Export – Shipper’s Letter Of Instructions (SLI)

SHIPPER'S LETTER OF INSTRUCTIONS
1.USPPI Name*
3.Freight Location Company Name*
2.USPPI Address Including Zip Code*
4.Freight Location Address (if not box #2)
5.Forwarding Agent:

Future Forwarding, 4380 International Parkway, Suite C, Atlanta, GA 30354, Tel: 404-608-0060
6.USPPI EIN (IRS) No*
7.Related Party Indicator (select one)*
- Related
- Non-Related
8.USPPI Reference#*
9.Routed Export Transaction (select one)*
- Yes
- No
10.Ultimate Consignee Name & Address*
11.Ultimate Consignee Type (select one)*
- Direct Consumer
- Government Entity
- Reseller
- Other/Unknown
12.Intermediate Consignee Name & Address*
13.State of Origin*
14.Country of Ultimate Destination*
15.Hazardous Material*
- Yes
- No
16. Prepaid or Collect*
17. Incoterm*
19. Insurance?*
- Yes
- No
INSTRUCTIONS TO FORWARDER*

20. Domestic or Foreign (D/F)	21. Schedule B / HTS Number and Commercial Commodity Description For Vehicles: VIN/Year, Make, Model and Vehicle Title Number are required	22. Quantity in Schedule B / HTS Units	23. DDTC Quantity and DDTC Unit of Measure	24. Shipping Weight (in Kilos)	25. ECCN, EAR99 or USML Category No.	26 . S M E (Y/N)	27. Export License No., License Exception Symbol, DDTC Exemption No., DDTC ACM No. or NLR	28. Value at the Port of Export (US Dollars)	29. License Value by item (if applicable) (US Dollars)

30.DDTC Applicant Registration Number*
31.Eligible Party Certification*
- Yes
- No
*
- 32 Check here if there are any remaining non-licensable Schedule B / HTS Numbers that are valued $2500.00 or less and that do not otherwise require AES filing.
*
- 33 Check here if the USPPI authorizes the above named forwarder to act as its true and lawful agent for purposes of preparing and filing the Electronic Export Information ("EEI") in accordance with the laws and regulations of the United States.
34.I certify that the statements made and all information contained herein are true and correct. I understand that civil and criminal penalties, including forfeiture and sale, may be imposed for making false and fraudulent statements herein., failing to provide the requested information or for violation of U.S. laws on exportation (13 U.S.C. Sec . 305: 22 U.S.C. Sec. 401, 18 U.S.C. Sec 1001, 50 U.S.C. app. 2410).
35.USPPI E-mail Address*
36.USPPI Telephone No.*
37.Printed Name of Duly authorized officer or employee*
38.Signature*
39.Title*
40.Date*
MM slash DD slash YYYY
- 41. Check here to validate Electronic Signature. Electronic signatures must be typed in all capital letters in Box 38 in order to be valid.

SHIPPER'S LETTER OF INSTRUCTIONS