FOREX JAPAN CO. LTD.

In the Philippines

4-3-1 Tokai, Ota-ku, Tokyo

Toll-Free: 0120-77-3583
Tel: 03-5755-7291
Fax: 03-5755-7292

UMAC FORWARDERS EXPRESS, INC.

130 Ipil Street Corner Ipil Ext.
Marikina Heights, Marikina City
Tel: +63-2-475-4229 / 475-4057
Fax: +63-2-475-4058

DECLARATION & PACKING LIST

Sender ()
Name:
Address:

Consignee ()
Name:
Address:

Tel:
E-Mail Address:

Tel:

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DESCRIPTION

DESCRIPTION

DESCRIPTION

Cloth

QTY/ AMT/

Shampoo

QTY/ AMT/

Bicycle

Shoes / Sandal

Conditioner

Air Pump

Cap / Hat

Soap

Ball

Belt

Hair Gel / Wax

Racket

Bag

Lotion

Musical Instrument

Wallet

Skin Cream

Watch

Cosmetic

TV (

Accesory

Perfume

Monitor

Tooth Brush

Printer

Canned Goods

Tooth Paste

PC Acc.(NO PC/CPU/MotherBoard!)

Candy

Sanitary Item

Chocolate

Diaper

Snack

Shaver

Coffee

Detergent

Audio Player

Coffee Cream

Dish Soap

DVD Player

DVD

Juice

Toilet Paper

CD / DVD

CD / DVD

Tea / Green Tea

Tissue Paper

Digital Camera

Liquor

Towel

Camera

Cup Noodle

Elec. Fan

Instant Noodle

Casserole / Pot

Phone (NO Mobile!)

Pasta / Somen

Pan / Frying Pan

Cord / Cable

Retort Food

Spoon/Fork/Knife

//

Instant Food

Chopsticks

iPod

iPod

Dried Food

Plate

iPad

iPad

Seasoning

Glass / Cup

Game Hardware (w/ Brand & Model)

Sauce

Tupper Ware

Brand:

Salt

Kitchen Ware

Sugar

Cooking Oil

School Supply

Stationery

Medicine

Book / Album

Supplement

Display Item

House Deco

Pet Food (NO Seeds!)

Furniture

Plastic Case

Carpenter Tool

Gardening Tool

PC(/CPU/)

Speaker / Amplifier / Tuner

(//)

Model:

Others (pls Specify/NO TAGALOG!!) ()

Bed Cover

Blanket

Futon

Toy

Pillow

Stuffed Toy

Cushion

Game Software

Curtain

Carpet

Tire

Mat

Rim

FOR FOREX USE ONLY

inch)

QTY/ AMT/

TOTAL:

FOR CUSTOMER
This is to certify that I am the sender of the above items: that the above detailed
list is the true and correct descriptions of the goods contained in this box being
sent to the Philippines.

Sender's Signature
()
Basic charge
Add: oversize
Other charges
Total amount
Date

IMPORTANT NOTICE
Valuable items like jewelries are no longer allowed to put inside the balikbayan box.
FOREX will not be responsible for any claim or lost of the above.
FRAGILE PERISHABLE OR IMPROPERLY PACKED ITEMS will be accepted at the sender's risk.
The company will not be liable for any damage or spoilage.
Please remit your payment immediately BEFORE Forex pick up your box.
Unpaid Forex boxes will be disposed after two months without prior notice. Thank you.

Customer's Copy ()