Importer Reference Number Today's Date Importer of Record Name Importer Tax ID# (only required if new customer) Consignee IRS Number (if different than importer of record)

Manufacturer / Supplier Name & Address Seller Name & Address (if same as Mfg, type 'Same') Buyer Name & Address Ship To Name & Address Container Stuffing Location (May be provided within 24 hours of arrival of vessel) Consolidator (if same as stuffing location, type 'Same') (May be provided within 24 hours of arrival of vessel) Vessel Name / Voyage ETD   Bill of Lading Number - MUST BE THE B/L THAT WAS FILED AMS MBL# Scac Code BL#   HBL# Scac Code BL#

Country of Origin Commodity / Description of Goods HTSUS Tariff # (6 Digit Level) This information must be subitted to Willmar International no later than 72 hours prior to vessel loading. Failure to comply with this requirement may result in penalties being assessed by US Customs against the Importer of Record.

Sender's Information Notes / Comments: Name Company Name Telephone Fax Email All Activities are Subject to Terms and Conditions