EXPORT TEAM USE ONLY

Sika R&D Sample SAP ORDER NUMBER:

Transport Request Form

ALL FIELDS MUST BE COMPLETED BEFORE SUBMITTING - 5 WORKING DAYS NOTICE IS REQUIRED

Date 13/01/2023
Requested By (full name) Mr Nathan Peeler

Delivery Company Name ParexGroup SAS

Delivery Address PAREXGROUP SA
- must include Zip Code 105 rue de Santoyon
- PO Box numbers not allowed Parc d’activités de Chesnes Nord
38070 Saint Quentin Fallavier
France
Delivery Contact Name Didier Dru
Delivery Contact Telephone Phone: +33 4 74 99 13 48 · Mobile: +33 6 73 84 83 40

Delivery Contact Email dru.didier@fr.sika.com ·

Is the sample FOC? (YES/NO) Yes

Company Contact
Who is paying freight? Sika Limited Panassakorn Jones
Name Name
Dimensions Weight
Packaging Type (pallet/box) Box 80 x 120 x 70 470
(cm - LxWxH) (kg)
Location of goods in warehouse Site A (Goods in)
Product Name
Quantity (number)
Unit Size (kg)
Batch Number (R&D use only)
Colour Reference (R&D use only)
Article/SGAN Code
(N/A = ONLY if not yet created)
Tariff/Commodity Code
(ALWAYS required)
Is it a non-stock item? (YES/NO)
Value of Goods for Customs
£5 £5 £5 £5 £5
(average sample = £2.50 per 0.5 kg)
Is the sample hazardous? (YES/NO)
UN Number
(found on MSDS)
If YES,
please Class
(found on MSDS)
complet
Packing Group
e these (found on MSDS)
codes UN Packaging Code
(found on packaging)
PLEASE EMAIL THIS COMPLETED FORM TO: EXPORT export@uk.sika.com UK ashcroft.leanne@uk.sika.com

Sika R&D Sample Transport Request Form