Invoice Page 1 From Tax ID/VAT No.: Waybill Number: Contact Name: Date: Shipment ID: Company Name: Address: Invoice Number (Reference 1): City State/Province: Purchase Order Number (Reference 2): Postal Code Country/Territory: Terms of Sale (Incoterm): Phone: Reason for Export: Ship To Sold To Tax ID/VAT No.: Tax ID/VAT Number: Contact Name: Contact Name: Company Name: Company Name: Address: Address: City State/Province: City State/Province: Postal Code Country/Territory: Postal Code Country/Territory: Phone: Phone: Units U/M Description of Goods/Part Number Harmonized Code Additional Comments : C/O Unit Value Total Value Currency Invoice Line total: Discount/Rebate: Invoice Sub-Total: Freight: Insurance: Other: Declaration Statement : Total Invoice amount: Shipper s Signature / Title Date Currency Total Number of Packages: Total Weight: These items are controlled by the U.S., E.U., other gov ts, authorized for export only to the country of ultimate destination for use by the ultimate consignee or end-user(s) herein identified..
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