Marushin Group, Inc.

SHIPPER INFORMATION

Name:

Name of business:

Nature of business:

E-mail address (required):

Daytime phone # (including country code and/or area code):

Fax # (including country code and/or area code):

Address:

City:

State:         Postal Code:

Country:

COMMODITY INFORMATION

Commodity description:

Location of commodity if not at shipper's address (include zip code):
Street Address:

City:

State:         Postal Code:

Country:

Destination:

Total number of pieces:

Please give weight and dimensions for each piece.
No. of pieces/length/width/height

SERVICES REQUIRED

Ocean    Air

Prepaid    Collect

Type(s) of services required:

Insurance needs:

Any additional requirements or comments: