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2005 UPS Rate and Service Guide

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Invoice<br />

Date:<br />

Bill of Lading/Air Waybill No.:<br />

Invoice Number:<br />

Purchase Order No.:<br />

Terms of Sale (Incoterm):<br />

Reason for Export:<br />

SHIP TO:<br />

Tax ID/VAT No.:<br />

Contact Name:<br />

Company Name:<br />

Company Address:<br />

City:<br />

State/Province:<br />

Postal Code:<br />

Country:<br />

Telephone No.:<br />

E-Mail ID:<br />

No.<br />

Units<br />

Unit of<br />

Measure<br />

Additional Comments:<br />

Declaration Statement:<br />

Shipper Signature/Title Date:<br />

SHIPPER INFORMATION:<br />

Tax ID/VAT No.:<br />

Contact Name:<br />

Company Name:<br />

Company Address:<br />

City:<br />

State/Province:<br />

Postal Code:<br />

Country:<br />

Telephone No.:<br />

E-Mail ID:<br />

SOLD TO:<br />

Tax ID/VAT No.:<br />

Contact Name:<br />

Company Name:<br />

Company Address:<br />

City:<br />

State/Province:<br />

Postal Code:<br />

Country:<br />

Telephone No.:<br />

E-Mail ID:<br />

Description of Goods<br />

(include Harmonized Tariff Number if known)<br />

PROCESS YOUR SHIPMENT<br />

Country<br />

of Origin<br />

Unit<br />

Value<br />

Invoice Line Total:<br />

Discount/Rebate:<br />

Invoice Sub-Total:<br />

Freight Charges:<br />

Insurance:<br />

Other (Specify type) :<br />

Invoice Total Amount:<br />

Currency Code:<br />

Total Number of Packages:<br />

Total Weight (indicate LBS or KGS):<br />

These commodities, technology or software were exported from the United States in accordance with the Export Administration<br />

Regulations. Diversion contrary to U.S. law is prohibited.<br />

Total Value<br />

115

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