Shippers Security Endorsement - Form

1 3333 Frederick Avenue, Baltimore Maryland 21229 Tel: 410-233-6696 Email: Transportation Security Administration shipper s Security Endorsement (SSE) I certify that this cargo does not contain any unauthorized explosives, incendiaries, or other destructive substances or items. I agree to a search of this cargo. I am aware that this Endorsement , and original signature, and other shipping documents, will be retained on file for at least 30 days. shipper s Name: Today s Date: Address: Telephone:__ _____ Email: _____ shipper s Signature or authorized Representative tendering the Cargo: _____ Name of Person whose signature appears above as shipper or authorized representative tendering the Cargo: _____ Air Waybill Number:_ _____ PERSONAL IDENTIFICATION INFORMATION The accepting agent must review and record either: 1.

2 One valid photo identification issued by a government authority, or: 2. Two other forms of valid identification of which at least one must be issued by a government authority If any ID presented contains an expiration date, the accepting agent must verify that it has not expired. Name on 1. US Driver s License: YES__NO__ Driver s License: _____ Driver s Exp. License #:_ _____State: _____ DOB: _____ Date: _____ OR 2. Passport: YES__NO__ Name on Passport:_____ Country:_____ DOB:_____ Exp. Date:_____