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2. MASTER BILL OF LADING NUMBER 3. ESTIMATED

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2. MASTER BILL OF LADING NUMBER
3. ESTIMATED DEPARTURE DATE 4. ESTIMATED ARRIVAL DATE 6. U.S. PORT OF UNLADING
8. VOYAGE NUMBER 9. OCEAN CONTAINER NUMBER 10. REFERENCE NUMBER
NAME: NAME:
ADDRESS: ADDRESS:
CITY: CITY:
STATE: STATE:
COUNTRY: COUNTRY:
POSTAL CODE: POSTAL CODE:
NAME: NAME:
ADDRESS: ADDRESS:
CITY: CITY:
STATE: STATE:
COUNTRY: COUNTRY:
POSTAL CODE: POSTAL CODE:
NAME: NAME:
ADDRESS: ADDRESS:
CITY: CITY:
STATE: STATE:
COUNTRY: COUNTRY:
POSTAL CODE: POSTAL CODE:
NAME: NAME:
ADDRESS: ADDRESS:
CITY: CITY:
STATE: STATE:
COUNTRY: COUNTRY:
POSTAL CODE: POSTAL CODE:
21. COUNTRY OF ORIGIN
Patrick Vasquez Customs Broker will be held harmless from liability for filing the Importer Security Filing resulting from any missing, discrepant or late information. Liabilities may include, but are
SHIPMENT DETAIL
1. AMS HOUSE BILL OF LADING NUMBER
5. FOREIGN PORT OF LADING
7. NAME OF VESSEL
SUPPLY CHAIN
IMPORTER SECURITY FILING
ISF 10+2
20. HTS NUMBER19. ITEM DESCRIPTION
not limited to penalties, exam fees or demurrage. To ensure that the ISF is transmitted to CBP no less than 24-hours prior to cargo being laden on-board the vessel, all required ISF data
elements including the bill of lading number must be provided no less than 72-hours prior to the vessels scheduled sailing date.
11. MANUFACTURER (SUPPLIER) 12. SELLER
13. BUYER 14. SHIP TO
15. CONTAINER STUFFING LOCATION 16. CONSOLIDATOR
17. IMPORTER OF RECORD 18. CONSIGNEE
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2. MASTER BILL OF LADING NUMBER 3. ESTIMATED

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Completed 2 November 2021

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