OMEGA

Customs Brokers Inc.


Please fill out the form completely.

Please tell us who you are and how we can contact you.

First Name:
Last Name:
Company Name:
Street Address:
City: State: Zip Code
Country:
E-Mail Address:
Telephone Number:
Fax Number:

IMPORT EXPORT

In order to provide you with a quote on our import services, we need for you to complete the following information.

Type of commodity
Approximate value per shipment
Number of imports per month
Mode of transportation Land Air Sea
Do you presently use a Customs Broker? Yes No
If yes, who?

Use this space if you have any questions, comments or remarks about importing.


In order to provide you with a quote on our export services, we need for you to complete the following information.

ORIGIN
City: State: Country:
DESTINATION
City: State: Country:

Please tell us about your shipments.
Shipments consist of:
Number of pieces: Weight Kilograms Pounds
DIMENSIONS
Length: Width: Height:
Please tell us what type of services you need.
door to airport Yes No Need insurance? Yes No
airport to airport Yes No Need pickup? Yes No
door to door Yes No
airport to door Yes No Freight is? Prepaid Collect

Use this space if you have any questions, comments or remarks about exporting.


Omega Customs Brokers Inc.
P. O. Box 52-0814
Miami, FL 33152

+1-305-592-5656
+1-305-592-7393 (FAX)


mail omegacb@omegacb.com


Page updated on: 2-/IX/96