IMPORTERS SECURITY FILING (AKA 10+2)

Please fill out all fields below and submit. All information must be provided prior to loading of the container onboard the vessel.

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Importer of Record (Shipper's full name as it appears on their passports):
Date of Birth:
Country of Citizenship:
Social Security or Passport Number (Including country of issuance):
Shipper's Foreign Address:
Shipper's U.S. Address:
Shipper's Anticipated Date of Arrival in the U.S.:
Booking Date of the Container:
Container Stuffing / Loading Location (Name and Address):
Projected Stuffing / Loading Date of the Container:
Consolidator's (Stuffer's) Name and Address (if LCL):
Container Number (if available):
Lowest Level Bill of Lading Number:
Vessel Name:
Voyage Number:
Preparer's Name:
Today's Date: