MSC BOOKING FORM TO RUSSIA

TO MSC Booking Agency

BKG # LEAD # INTRA #
B/L #

Booking party
FULL NAME PT SAMUDRA PASIFIC MAJU
ADDRESS JL PERAK TIMUR 512 BLOK G8 -
BOOKING PARTY SURABAYA

PHONE NUMBER +6231-3287575

WEBSITE www.spm.co.id

Routing / Tracking
Place of Receipt (City / Country) SURABAYA
Port of Loading (Port / Country) SURABAYA
Port of Discharge (Port / Country) SAINT PETERSBURG
Place of Delivery (City / Country) SAINT PETERSBURG

Commodity
Full cargo description HS CODE* (min. 6 Purpose of the cargo (specific use and
digits) industry)
Coconut Charcoal 4402.90 COCONUT CHARCOAL FOR SHISHA

* In accordance with the EU HS code and 1 HS code per commodity.

Shipper
FULL NAME PT COCOURTH COCONUT COAL INDONESIA
ADDRESS* JL KERTOREJO GAJAH NO 7 DS KERTOREJO KEC NGORO KAB
JOMBANG – 61473
PHONE NUMBER +62321 6870807
WEBSITE
COMMERCIAL ACTIVITY ** EXPORTIR CHARCOAL BRIQUETTES PRODUCT
* PO BOX is not accepted/Physical address mandatory
** Commercial activity must be specific and detailed.

*TO ORDER OF [name of company/bank]” booking can be accepted provided that the Agency has received from the
Shipper a written confirmation (a confirmation via email is acceptable) stating the name of the Real Receiver. The Real
Receiver must appear on the Booking Evaluation Form under the Real Receiver section

Consignee
FULL NAME EUROTRANSTOVAR LLC
ADDRESS* ZASTAVSKAYA STR . HOUSE 14A LIT M. OFFICE 9
SAINT PETERSBURG 196084
RUSIAN FEDERATION

PHONE NUMBER +7 812 718 6970 (246)

WEBSITE
COMMERCIAL ACTIVITY ** IMPORTIR CHARCOAL BRIQUETTES PRODUCT
*In case of ” TO ORDER OF [name of company/bank]” booking and if neither the First nor the Second Notify is the
Real Receiver, this party must be added under the present section.

Real Receiver
FULL NAME
ADDRESS*

PHONE NUMBER
WEBSITE
COMMERCIAL ACTIVITY**

Notify (if necessary)

FULL NAME
ADDRESS*

PHONE NUMBER
WEBSITE
COMMERCIAL ACTIVITY**

* PO BOX is not accepted/Physical address mandatory

** Commercial activity must be specific and detailed.

Second Notify Party (if necessary)

FULL NAME
ADDRESS

PHONE NUMBER
EMAIL

Note to Agency: Please add any local requirements for booking, including as required by local law

We hereby declare that the above mentioned information is true and to best of our knowledge and will be reflected in
the shipping instructions pertaining to this booking.
Name and Position of undersigned
Authorized Signature, Date and Stamp
To be completed by MSC / For MSC use only :
Booking reference:
Vessel / Voyage: