US Customs Service/NICB

VEHICLE EXPORT WORKSHEET

When faxing vehicle title, please fax both sides.
Items marked with "*" are required.

Title / MSO / Salvage Certificate

DMV / DOL Certification

Bill of Sale / MSO / Equipment

 

 

Please describe vehicle or equipment:

*VIN/SN:

*Year:

*Make:

*Model:

*Type:

Custom Use Only: 3004

Tracking #: BL

Date:

# of Pages:

 

Wheeled

Tracked

 

Title Information:

*Title # and issuing State:

Type of Title:

Duplicate

Copy

Salvage

Flood

Rebuild

Untitled

Type of title not required if exporter/agent presents an original title with no caveats or special headings.

What land carrier company will transport the vehicle:

Carrier/Company:

Distribution Port:

*Est. Date of Export:

Owner/Exporter

*Name:

*Address:

What commercial firm is arranging transportation:

Name:

Address:

Who is the consignee or responsible party at the foreign port (if not owner / exporter):
The following information is required if the vehicle is shipped to Canada, and the receiving party is not the same as the owner or exporter.

Name:

Address:

Country:

Phone #: