Section 1 — Shipment Information

Shipment Type *

Air Freight

Sea Freight

Direction of Shipment *

Export (From Liberia)

Import (Into Liberia)

Origin Country *

Origin City *

Purpose of Shipment *

Personal Use

Commercial Use

Gift / Family Support

Humanitarian Aid

Other

Destination Country *

Destination City *

Estimated Cargo Ready Date

Requested Shipment Date

How did you hear about Let Ship Africa?

Facebook

Referral

Google Search

Website

Existing Customer

Other

Section 2 — Customer / Shipper Information

Full Name *

Business Name (if applicable)

Phone Number *

WhatsApp Number

Email Address *

Government ID / Passport Number

Street Address *

City *

Postal Code

Country *

Section 3 — Consignee Information (Receiver)

Full Name *

Business Name (if applicable)

Phone Number *

WhatsApp Number

Email Address

Street Address *

City *

State / Province

Postal Code

Country *

Section 4 — Importer of Record Information

Is the Consignee also the Importer of Record? *

Yes

No

If No, please complete the importer's details below:

Full Name

Business Name

Phone Number

Email Address

Importer Tax ID / EIN / ABN / VAT Number

Country

Section 5 — Cargo Information

Number of Packages

Estimated Weight (KG)

Estimated Dimensions (Optional)

Estimated Cargo Value (USD)

Does your shipment contain dangerous or hazardous goods? *

No

Yes

Section 6 — Documentation Available

Please indicate available documents:

Commercial Invoice

Packing List

Export Permit

Health Certificate

Phytosanitary Certificate

Certificate of Origin

Product Labels

Product Photos

Other

Section 7 — Optional Services Requested

Customs Brokerage Assistance

Import Compliance Assistance

FDA Compliance Assistance

Warehouse Receiving

Cargo Insurance

Documentation Assistance

Local Delivery

Export Processing Support

Product Sourcing Assistance

Cargo Collection within Liberia

Cargo Packaging

Customs Documentation

Other

Section 8 — Special Instructions

Section 9 — Customer Compliance Checklist

Please confirm the following:

I have accurately declared all items in this shipment.

I understand additional documentation may be required.

I understand customs and regulatory inspections may occur.

I understand shipment acceptance is subject to export and import regulations.

I understand false declarations may result in delays, penalties, seizure, rejection, or destruction of cargo.

I understand that Let Ship Africa Inc. may request additional information before accepting cargo.

I understand that destination-country requirements may vary.

Preferred Communication Method — How would you like us to contact you? *

Phone Call

Email

Preferred Contact Time

Section 10 — Customer Declaration

I certify that all information provided in this form is true, accurate, and complete. I confirm that the shipment does not contain prohibited, restricted, illegal, counterfeit, hazardous, dangerous, undeclared, or misrepresented goods. I acknowledge that customs authorities, regulatory agencies, airlines, shipping lines, warehouses, brokers, and other parties may inspect the shipment. I understand that shipment acceptance remains subject to compliance review and applicable regulations.

I have read, understood, and agree to the declaration above. *

Customer Name (typed as signature) *

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Section 1 — Shipment Information

Section 2 — Customer / Shipper Information

Section 3 — Consignee Information (Receiver)

Section 4 — Importer of Record Information

Section 5 — Cargo Information

Section 6 — Documentation Available

Section 7 — Optional Services Requested

Section 8 — Special Instructions

Section 9 — Customer Compliance Checklist

Section 10 — Customer Declaration