| Date of Export:: 
 
 | Export References (i.e. order no., invoice no., etc): 
 
 | 
         
          | Shipper/Exporter (complete name and address): 
 
 
 
 
 
 | Recipient (complete name and address): 
 
 
 
 
 
 | 
         
          | Country of export: 
 
 | Importer - if other than recipient (complete name and address):
 | 
         
          | Country of manufacture: 
 
 | 
         
          | Country of ultimate destination: 
 
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          | Federal Express International Air Waybill Number: 
 
 | Currency: 
 
 | 
         
          | Marks/Nos | No. of pkgs
 | Type of packaging
 | Full Description of goods
 | Qty | Units of measure
 | Weight | Unit value | Total Value
 | 
         
          | 
 | 
 
 
 
 
 
 
 
 
 
 
 
 | 
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 | 
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          |  | Total No. of
 Pkgs
 |  | Total Weight
 |  | Total Invoice
 Value
 | 
         
          |  | 
 
 
 |  | 
 
 
 |  | 
 
 
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          | 
            
             
              | I declare all the information contained in this invoice to be true and correct 
 |  
              | Signature of shipper/exporter (type name and title and sign) 
 __________________________________________
 | Date: 
 ___________
 |  | Check One 
 |