LETTER OF INTENT TO EXPORT

                                                                                      RECEIPT NUMBER:___________________

 EXPORT USED VEHICLE INFORMATION SHEET    DATE/TIME RECEIVED:                             DATE/TIME RELEASED:

VEHICLE INFORMATION

VIN #         ____________________________   LICENSE PLATE # _______________    STATE __________

YEAR        __________   MAKE   __________   MODEL  _______________________    COLOR __________   

DOCK NAME / LOCATION

FOR INSPECTION__________________________________________________________________________

 EXPORTER INFORMATION

OWNERS NAME  __________________________________________________________________________

ADDRESS ________________________________________________________________________________

                     STREET                                                   CITY                                     STATE/COUNTRY                     ZIP CODE

DRIVERS LICENSE # _______________________________    STATE/COUNTRY ____________________

SOCIAL SECURITY #

OR PASSPORT NUMBER/COUNTRY ________________________       DATE OF BIRTH _________________

SHIPPER/AGENT/FORWARDER  _____________________________________________________________

CONTACT PERSON ______________________  TEL #  __________________FAX # ____________________ 

 EXPORT INFORMATION 

SHIPPING COMPANY   ________________________________)TEL# ____________  FAX# _____________

VESSEL & VOYAGE #  _______________________________  BOOKING # ___________________________

SAILING / FLT DATE   ___________________________________   CONTAINER # _____________________

PORT OF EXPORTATION ________________ PORT AND COUNTRY OF DESTINATION _________________

CONTAINERIZED:  YES ____   NO ____     CONTAINER # ____________   CONTAINER WEIGHT __________ 

AUTHORIZED SHIPPING COMPANY REPRESENTATIVE_______________________________

                                                                                                                                  PRINT NAME

SIGNATURE ________________________________________________DATE _______________

Vehicle must be delivered to exporting carrier before presentation of the documents to Customs. 

Compliance is mandatory.  Carriers and exporters are liable for penalties set forth in 19 CFR Part 192 – Export Control.