EFTA00522399.pdf

Tropicgl Worlds Of Service WRITTEN AUTHORIZATION TO PREPARE OR TRANSMIT SHIPPERS EXPORT INFORMATION I hereby authorize Tropical Shipping USA, LLC, to act for and on our behalf as Agent to transmit any Electronic Export Information (EEI) to the United States Census Bureau, which may be required by law or regulation in connection with the exportation or transportation of any merchandise on behalf of said U.S. Principal Party in Interest. The U.S. Principal Party in Interest (USSPPI) certifies that ALL necessary and proper documentation to accurately transmit the information electronically is and will be provided to TROPICAL SHIPPING USA, LLC, in accordance with established document cutoffs as published on Carrier's website (www.trooical.com). The U.S. Principle Party in Interest further understands that civil and criminal penalties may be imposed for making false or fraudulent statements or for the violation of any United States laws or regulations on exportation and agrees to be bound by all statements of information or documentation provided by the U.S Principle party in Interest to said agent. (Select one - circle the applicable choice) Company or Individual Name: Employer Identification Number (EIN) or Dun & Bradstreet Number (DUNS) or Passport Number (foreign entities only) Street Address: City: State: Zip Code: Phone number: Fax number: Email address: Please check one of the following: This authorization covers all shipments for the above USPPI This authorization cover only Job Number: If company: Authorized Representative Name: Signature:— Date: For Tropical Shipping. LLC use only: Partner ID (Account number): EFTA00522399