EFTA00520738.pdf

IMPORTER SECURITY FILING (TSF) INFORMATION SHEET Items 1-7 to be completed by shipper/agent & verified by ISF Filer. (1) Seller Name and Address (2) Buyer Name and Address OMBRELLIF1CIO ADRIAMARE DI VIA TAMIGI 6100 RED HOOK QUARTERS SUITE 8-3 65016 MONTESILVANO (PE) 00802 ST. THOMAS (3) Consoidator (Stuffer) Name and Address (4) Container Stuffing Location Name and Addmss CENTRAL SHIPPING AGENCY SPA CENTRAL SHIPPING AGENCY SPA VIA LUDOVICO DI BREME. 27 VIA PAPA GIOVANNI )OUll, 2 20156 MILANO 20060 LISCATE ND Per ISF Rule, HTSUS, Country of Origin and Manufacturer must be inked to one another at the line item level. Add additional sheets for additional HTSUS numbers. (5)Cornmodity,HTSUS Number(s) and Address (6) Country of Origin (7) Manufacturer Name and Address ITALY OIABREuiRCLO AMP/WARE DI VIA TAMIGI I 65018 MONTESILVANO (PE) (8) Importer of Record No. (9) Consignee No, I To be completed by fonvardedagent House Bill of Lading Master BAP Vessel Name Voyage No. 11.1007956 (scae code SAIJ) 111560188 (scae code CHOU) ROME EXPRESS 2F183W Date of Departure Port of Departure Container Number Loadng Date 12/21/12 GENOA, ITALY CAXU 976568/9 12/20/12 ISF Fier Information: DataMme Received ISF Form Received By Date/Time Procees Confirmation # This form must be completed in English aid provided to us, no later than 72 hour pnor to sailing. EFTA00520738