Exportation Sheet For Boats & Jet Skis Form

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BOOKING: VSSL_______________________VESSEL/VOYAGE:____________________DOCK RECEIPT:________________________

FINAL DESTINATION:

SAN JUAN

JACKSONVILLE

ST THOMAS

ST CROIX

BOAT:

JET SKI:

OTHER:

____________________________________________________

YEAR: _____________________

MAKE: __________________________________

MODEL: _________________________________

WEIGHT: _________________________ HULL NO: __________________________ INBOARD or OUTBOARD: ___________________

SHIPPER’S NAME/NOMBRE DEL

EXPORTADOR:_____________________________________________________________________________________________________

(Origin or Who is Sending / Origen o Quien lo Envía)

ADDRESS/DIRECCIÓN: ______________________________________________________________________________________________

(Complete Physical Address / City / State & Zip Code / Dirección Física completa / Ciudad / Estado y Código Postal)

TELEPHONE/TELÉFONO: ___________________________________

EMAIL:_______________________________________________

SHIPPER’S EMPLOYER IDENTIFICATION NUMBER (EIN): ____________________________________________

(Non-US Citizens, please use Passport Number)



FOR US CUSTOMS PURPOSES, PLEASE LIST VALUE OF VESSEL $ ____________________________

TRAILER: YEAR: _____________ MAKE: __________________________ MODEL:__________________________________________

WEIGHT: ______________________ VIN NO: ___________________________________________________________________________



FOR US CUSTOMS PURPOSES, PLEASE LIST VALUE OF TRAILER $ ____________________________

IS SHIPPER THE SAME FOR THE TRAILER AS THE BOAT/JET SKI OR OTHER? Yes or No

IF NO, PLEASE PROVIDE SHIPPER DETAILS BELOW FOR THE TRAILER:

SHIPPER’S NAME/NOMBRE DEL

EXPORTADOR:_____________________________________________________________________________________________________

(Origin or Who is Sending / Origen o Quien lo Envía)

ADDRESS/DIRECCIÓN: ______________________________________________________________________________________________

(Complete Physical Address / City / State & Zip Code / Dirección Física completa / Ciudad / Estado y Código Postal)

TELEPHONE/TELÉFONO: ___________________________________

EMAIL:_______________________________________________

CONSIGNEE’S NAME/NOMBRE DEL

CONSIGNATARIO:___________________________________________________________________________________________________

(Who will received it at last destination / Quien lo recibe en el último destino)

ADDRESS/DIRECCIÓN: _______________________________________________________________________________________________

(Complete Physical Address / City / State & Zip Code / Dirección Física complete / Ciudad / Estado y Código Postal)

TELEPHONE: ______________________ E-MAIL ADDRESS: ___________________________________________

Authorization to File the Electronic Export Information to the U.S. Census Bureau

In accordance with 15 CFR 30.3(f), I hereby authorize TOTE Maritime Puerto Rico, LLC. to file the required Electronic Export Information (EEI) into the

government’s Automated Export System (AES) for this shipment. We understand that this filing is required by U.S. Department of Census and is being enforced by

Customs and Border Protection (CBP) for all merchandise subject to statistical reporting and/or licensed merchandise. All documentation submitted will be made

available to CBP upon request. I further certify that I am the person familiar with the merchandise being forwarded and release TOTE Maritime Puerto Rico, LLC.

officers and employees of all claims, demands, causes of action, damages, costs, and expenses, arising out of, incident to, or resulting directly or indirectly from the

Principal Party in Interest’s provision of incomplete or inaccurate information or statements to TOTE Maritime Puerto Rico, LLC

SIGNATURE/FIRMA: _________________________________

EIN: ______________________

DATE/FECHA:___________________

Copy of Boat Title or authorization from the Financial Institution, if financed, or Bill of Sale

Copy of Trailer Title or Bill of Sale

Revised Nov 2015