Order Number:_________ Customer Number: Class Number_________ Order Candy Type:_________

Ship To Name: _________ Address: UNT LSCM 3960

Order Complete: (Yes/No)

Back Ordered: (Yes/No)

MOT: (A/O/T)

Date:_________

1. Purchase Order (Sales)

Supplier:
Attention:

Quantity:

Ship To:
Customer
P.O.
Number
Attention:

Part Number:

Bill To:
Distributo
r P.O.
Number

Description:

Price Each:

Extended:

2. Commercial Invoice (Finance)

DATE:
INVOICE MUMBER:
SHIPPER NAME:
P.O. NUMBER:
STREET ADDRESS:
COSIGNEE NAME:
CONTACT (SHIPPER):
STREET ADDRESS:
TELEPHONE/FAX NUMBER:
CONTACT (CONSIGNEE):
TAX ID NUMBER (EIN):
TELEPHONE/FAX NUMER:
EXPORTING CARRIER: New Penn Motor Express
TAX ID NUMBER (ie EIN, VAT):
OTHER INFORMATION (ie ITIN):
Complete
HM
Schedule B
Country of
Quantity:
Unit Price
Commodity
Manufacture
UMO
USDS
description

Total Price
USDS

*We hereby certify that the information on this invoice is true and correct and that the contents of this
shipment are as stated above.
Signature of Authorized Person:
Title:
Date:

3. Warehouse Packing List (Logistics Manager)

Sold To:
Item Number:

Quantity
Ordered:

Packed By:
Weight:
Cartons:
Delivery: (Partial/Complete)
Backordered Number:
Delivery By:

Quantity
Shipped:

Ship To:
Description:

Unit Price:

Subtotal:
Shipping & Handling:
_____% Tax
Total:

Total Amount:

Order Number:_________ Customer Number: Class Number_________ Order Candy Type:_________

Ship To Name: _________ Address: Unt LSCM 3960
Order Complete: (Yes/No)

Back Ordered: (Yes/No)

MOT: (A/O/T)

Date:_________

4. Bill of Lading (Forwarder)

Shipper:
Consignee:
Precarriage By:
Vessel:
Port of Receipt:
Port of Loading:
Port of Discharge:
Place of Delivery:

Container & Seal

Number(s)
Marks/Numbers:

Type of B/Lading:
o Original
o Express

Number of
Packages:

Booking Number:
Forwarder:
FMC Number:
Rate Reference Number:
Temperature Control Range:
From_____C to: _____F
Dangerous Goods Consignments Require:
o Shippers Declaration
o Container Packing Certificate
o Emergency Response Information
Type of Movement: (Air/Ocean/Truck)
Description of
Gross Weight in
Measurement in
Packages and
Kilos:
CBM:
Goods:

Ocean Freight:
o Prepaid
o Collect

Document Release Instructions:

Destination
Prepaid Invoice
Terminals:
Payable By:
o Prepaid
o Collect
Call for Pickup of Documents:
Phone:

5. 3461-Immediate Entry- (7501-Entry Summary Duty Payment)-Broker

1. ARRIVAL DATE:
5. PORT

9. IMPORTER NUMBER:

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection
ENTRY/IMMEDIATE DELIVERY
19 CFR 142.3, 142.16, 142.22, 142.24
2. ELECTED ENTRY
3. ENTRY TYPE CODE
DATE:
NAME:
6. SINGLE TRANS.
7.BROKER/IMPORTER
BOND:
FILE NUMBER:

4. ENTRY NUMBER:
8. COSIGNEE NUMBER:

11. IMORTER OF
RECORD NAME:
15.VESSEL
CODE/NAME:

12. CARRIER CODE:

17. MANIFEST NUMBER:

10. ULTIMATE
CONSIGNEE NAME:
14. LOCATION OF
GOODSCODE(S)NAME(S):
18. C.O. NUMBER

19: TOTAL VALUE:

21. IT/BLAWS CODE:

22. IT/BLAWS NUMBER:

23. MANIFEST
QUANTITY:

20. DESCRIPTION OF
MERCHANDISE:
24. H.S. NUMBER:

13. VOYAGE/FLIGHT
TRIP:

16.U.S. PORT OF
UNLADING:

25. COUNTRY OF
ORIGIN

26.MANUFACTURER
NUMBER:

CBP
EXAMINATION
REQUIRED
DATE:

ENTRY
REJECTED
BECAUSE:

SIGNATURE OF APPLICANT:

PHONE NUMBER:

29. BROKER OR OTHER GOVT

AGENCY:

28. CBP USE ONLY:

27: CERTIFICATION:

DELIVERY AUTHORIZED:

SIGNATURE:

DATE: