EFTA00606375.pdf

7ropical SHIPPING BUSINESS FORM WRITTEN AUTHORIZATION TO PREPARE OR TRANSMIT SHIPPER'S EXPORT INFORMATION hereby authorizes Tropical Shipping and Company Name Construction Company Limited, to act for and on its behalf as Agent to transmit any Shipper's Export Declaration (SED) information electronically to U.S. Census, which may be required by law or regulation in connection with the exportation or transportation of any merchandise on behalf of said U.S. Principal Party in Interest. The U.S. Principal Party in Interest (USPPI) certifies that ALL necessary and proper documentation to accurately transmit the information electronically is and will be provided to TROPICAL SHIPPING AND CONSTRUCTION COMPANY LIMITED ONE (1) BUSINESS DAY PRIOR TO SAILING. The U.S. Principal Party in Interest further understands that civil and criminal penalties may be imposed for making false or fraudulent statements or for the violation of any United States laws or regulations on exportation and agrees to be bound by all statements of information or documentation provided by the U.S. Principal Party in Interest to said agent. Export Identification Number (EIN): Company address: (NO PO BOX ACCEPTED) City. State, Zip: Phone & fax: Name: (U.S. Principal Party in Interest) Print Signature: Job Title Date NOTE: All above information must be provided in order to comply with U.S. regulations, and properly transmit your SHIPPER'S EXPORT DECLARATION. Authorization form will be kept in our files for a period of five years unless otherwise specified. Please check one of the following: This authorization covers all shipments for above USPPI This authorization applies only to shipment For Tropical Shipping and Construction Company Limited use only: Partner Number in T-Link added by Dept ext Date Rev 11/05-Business EFTA00606375