Transcription of Form 7525-V, Shipper's Export Declaration
1 FORM 7525-V (7-25-2000)OMB No. DEPARTMENT OF COMMERCE CENSUS BUREAU Economics and Statistics Administration BUREAU OF Export ADMINISTRATIONSHIPPER S Export DECLARATION1a. PRINCIPAL PARTY IN INTEREST (USPPI)b. USPPI EIN (IRS) OR ID PARTIES TO TRANSACTION4a. ULTIMATE CONSIGNEEb. INTERMEDIATE CONSIGNEE5. FORWARDING AGENT8. LOADING PIER (Vessel only)10. EXPORTING CARRIER12. PORT OF UNLOADING (Vessel and air only)ZIP CODE9. METHOD OF TRANSPORTATION (Specify)11. PORT OF EXPORT13. CONTAINERIZED (Vessel only)2. DATE OF EXPORTATION3. TRANSPORTATION REFERENCE POINT (STATE) OF ORIGIN OR FTZ COUNTRY OF ULTIMATE DESTINATION14.
2 CARRIER IDENTIFICATION CODE15. SHIPMENT REFERENCE ENTRY NUMBER17. HAZARDOUS MATERIALS18. IN BOND CODE19. ROUTED Export TRANSACTIONR elatedNon-relatedYesNoYesNoYesNo20. SCHEDULE B DESCRIPTION OF COMMODITIES (Use columns 22 24)(21)(22)(23)(24)D/For MSCHEDULE B NUMBERQUANTITY SCHEDULE B UNIT(S)SHIPPING WEIGHT (Kilograms)(25)VIN/PRODUCT NUMBER/VEHICLE TITLE NUMBER(26)VALUE ( dollars, omit cents)(Selling price or cost if notsold)27. LICENSE EXCEPTION SYMBOL/AUTHORIZATION28. ECCN (When required)29. Duly authorized officer or employeeThe USPPI authorizes the forwarder named aboveto act as forwarding agent for Export control andcustoms certify that all statements made and all information contained herein are true and correct and that I haveread and understand the instructions for preparation of this document, set forth in the "Correct Way toFill Out the shipper s Export Declaration .
3 " I understand that civil and criminal penalties, includingforfeiture and sale, may be imposed for making false or fraudulent statements herein, failing to providethe requested information or for violation of laws on exportation (13 Sec. 305; 22 ; 18 Sec. 1001; 50 App. 2410). No. (Include Area Code)31. AUTHENTICATION (When required)E-mail addressConfidential For use solely for official purposes authorized by theSecretary of Commerce (13 301 (g)). Export shipments are subject to inspection by Customs Serviceand/or Office of Export form may be printed by private parties provided it conforms to the official form.
4 For sale by the Superintendent of Documents,Government Printing Office, Washington, DC 20402, and local Customs District Directors. The "Correct Way to Fill Out the shipper sExport Declaration " is available from the Census Bureau, Washington, DC 20233.(Complete name and address)(Complete name and address)(Complete name and address)(Complete name and address)FORM 7525-V CONTINUATION SHEET (7-25-2000)OMB No. DEPARTMENT OF COMMERCE CENSUS BUREAU Economics and Statistics Administration BUREAU OF Export ADMINISTRATIONCONTINUATION SHEET TO shipper S Export DECLARATION9. METHOD OF TRANSPORTATION (Specify)11. PORT OF EXPORTPage _____ of _____pages20.
5 SCHEDULE B DESCRIPTION OF COMMODITIES (Use columns 22 24)(21)(22)(23)(24)D/For MSCHEDULE B NUMBERQUANTITY SCHEDULE B UNIT(S)SHIPPING WEIGHT (Kilograms)(25)(26)VIN/PRODUCT NUMBER/VEHICLE TITLE NUMBERVALUE ( dollars, omit cents)(Selling price or cost if notsold)27. LICENSE EXCEPTION SYMBOL/AUTHORIZATIONFor use solely for official purposesauthorized by the Secretary ofCommerce (13 301(g))This form may be printed by private parties provided it conforms to the official form. For sale by the Superintendentof Documents, Government Printing Office, Washington, DC 20402, and local Customs District Directors. The"Correct Way to Fill Out the shipper s Export Declaration " is available from the Census Bureau,Washington, DC COUNTRY OF ULTIMATE DESTINATION28.
6 ECCN (When required)DO NOT USE THIS AREA
