Custom-Broker Assisted Outbound Shipping Authorization
Exporter Information
Exporter Name
Exporter Address
Contact Number
Consignee Information
Consignee Name
Consignee Address
Contact Number
Customs Broker Details
Broker Name
Broker Company
License Number
Shipment Details
Shipping Date
Shipping Method
Number of Packages
Goods Description
Authorization
Authorized Person Name
Title/Position
Date
Signature