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C069-0110-6 4/11/04 4:24 pm Page 1


Note No. __________________________________________

2 Ship To: Consignment

Note No. __________________________________________
Company Name____________________________________________________________________________

Street ___________________________________________________________________________________________________________ Carrier

Town __________________________________________________________________________________________
Total Weight____________________________________________
State/Country __________________Area Code/Zip Code ___________________
Contract name______________________________________________________________________________

Tel/Telex/Fax No.___________________________________________________________________________ No. of pieces. __________________________________________

Commodity No. Items Total Value Currency

3 Full Description of Goods 4 5 6 7 8
Codes of Items Value for Customs (eg: GBP)

9 Shipper’s VAT No.

10 Name and Address of Manufacturer _________________________________________________________________________________________________________


11 Reasons for Export _______________________________________________________________________________________________________________________________


12 I declare that the above information is true and correct to the best of my knowledge,

and the goods are of________________________________________________origin

13 For and on behalf of the above named company. Date _____________________________________________________________

Name (in Print)______________________________________________________Signature_____________________________________Title _______________________

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For all goods other than documents, an invoice must accompany each shipment to be exported. If the goods are for sale,
a commercial invoice must be used. Where no commercial invoice is available, the exporter must complete a pro forma
invoice (This is NOT required for those countries within the European Union). This is a declaration for customs purposes.
A sample pro forma is given overleaf. This may be photocopied and completed as follows:

•• Load your photocopier with your company letterheads and run off 4 copies
Customs prefer all invoices to be typed. Complying with their requests helps alleviate possible problems and delays

1 Consignment note No., weight (if known), No of packages and dimensions.

The full name and address, including contact and Telephone/Fax/Telex No.
Remember we cannot deliver to a PO Box No. Telephone/Fax/Telex Nos are vital!

Full description of goods. For videos see note C below. OPTIONAL - If you have the customs tariff code for the
3 product you are sending, insert it alongside the description of goods.

4 Commodity Codes - Customs code required for each item when total invoice amount is £600.00 or over, for non EU
countries only.

5 Number of items. (ie: quantity of goods inside package.)

6 Value of each item.

7 Total value for customs for each product type, this must be at least the intrinsic value. (ie: value of a
video cassette or computer disc without recorded data).

8 Currency of goods - eg (GBP) Great Britain Pound.

9 Insert your own VAT number here. If you are not registered insert “UNREG”, If you are a private shipper insert “PR”.

10 The full name and address of the manufacturer, which is vital for many destinations.

11 Reason for export - (ie: samples not for re-sale, goods for test, evaluation).

12 Insert country of origin.

13 Sign each invoice, print name, date, title.


a Initial City Link does not under any circumstances carry, accept or deal with any noxious, dangerous, hazardous,
radioactive, inflammable or explosive goods nor any goods likely to cause damage.

b Computer parts, printed circuits (etc) may require an Export Licence. Please check with the Department of Trade and
Industry for details.

c When sending video/films include the length, width and subject matter - (USA require video declaration form) contact
your local depot.

Please note this document is for advice purposes only and the Customer is responsible for the correct completion of
export documentation and the production of the necessary documents.

Initial City Link require four (4) copies of a pro forma or commercial invoice.These must be attached
securely to the outside of the package.

Head Office: Initial City Link Limited, Wellington House, 61-73 Staines Road West, Sunbury-on-Thames, Middlesex TW16 7AH
Telephone: (01932) 822622 Fax: (01932) 785560
© 1992 Initial City Link Ltd. a Rentokil Initial company
Initial City Link does not accept any responsibility or liability for any claims arising out of the incorrect completion and
submission of documentation by the customer.
All business is undertaken in accordance with our Standard Trading Conditions, copies can be supplied upon request and as
featured in our Step-by-Step user guide and on the Web at