Fillable Request Form - U.S. Embassy Official Letter (International Trade Administration)

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Request Form - U.S. Embassy Official Letter (International Trade Administration)

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The Request Form - U.S. Embassy Official Letter (International Trade Administration) form is 2 pages long and contains:

  • 3 signatures
  • 9 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

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Request Form - U.S. Embassy Official Letter
for Import of U.S. Medical Devices and Defense Equipment
Date: ______________________
Certificate of Free Sales / Foreign Government No. / Letter Date: _________________________________
U.S. Company
Thai Company
Fee & Payment
I certify that the above information is truthful.
Signature of Thai/U.S. representative: _____________________
Company Name: ______________________________________________________________________________
Contact person name: _________________________________Title: ____________________________________
Address: ____________________________________________________________________________________
____________________________________________________________________________________________
Phone: __________________________________________ NAICS Code: ________________________________
E-mail: ___________________________________________ Website: __________________________________
Number of employees Worldwide: __________________Annual Sales ($US): ____________________
Company Name: ______________________________________________________________________________
Address: ____________________________________________________________________________________
____________________________________________________________________________________________
President/Managing Director: ____________________________________________________________________
Your name: ________________________________________ Title: _____________________________________
Phone: ___________________________________________ Email: _____________________________________
When do you plan to import products from this U.S. company? ( 
 
Month (): _____________________________________ Year ( ): __________________________________
Value of U.S. imports (
  U.S.): __________________________________________________
The U.S. Embassy may contact you to confirm the imports of U.S. products or services for internal use only.
Payment: Credit card online only. You will receive a secure payment link via email.

:
  

Please do not check the box below if you do not know the size of the company based on NAICS code.
see instructions)
Company Size (based on NAICS code and
Annual Sales/Number of Employees)
3 Days Service
Next Day Service*
Same Day Service*
Small
$100
$125
$150
Medium
$200
$250
$275
Large
$300
$375
$400
*For Next/ Same Day Service, please email of call in advance.
Contact: office.bangkok@trade.gov or Office Phone: 02-205-5090
1   

office.bangkok@trade.gov   
This form and supporting document must be delivered in person, please call if you have questions.
PA #_________________
Emb Letter #__________
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signature
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Send and Receive Form - U.S. Embassy Official Letter
–
 
Name of U.S. Company : _______________________________________________________________
Name of Thai Company: _______________________________________________________________
Sender/Messenger’s Name

 
: _____________________________________________________________
Mobile Phone/: _______________________________________________________________________
No. of Document 
_________________
Submission Date :
Signature of Sender:


:
Official Signature:

:
Please bring this document to present with the official staff when you are sending or receiving document.
   

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Request Form - U.S. Embassy Official Letter (International Trade Administration)

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Completed 19 April 2021

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