Order form

Customer name *

E-mail adres

Job reference *

Order type *

Plan group

Container type (ISO Code) *

Shipping company (no forwarder) *

Optional elements

ADR		Beun		Flatrack
Fyco		Gasmeting		Genset
Keuren		Kiepen		Wegen
Scan		NVWA		Douane

Cargo opening date

mm/dd/yyyy

Cargo opening time

Cargo closing date

mm/dd/yyyy

Cargo closing time

Reefer temperature

Pick up date

mm/dd/yyyy

Pick up time

Reference *

Pick up adres

Adres veterinary check

Loading date

mm/dd/yyyy

Loading time

Loading reference

Loading adress

Unloading date

mm/dd/yyyy

Unloading time

Unloading reference

Unloading adress

Remarks

Turn in date

mm/dd/yyyy

Turn in time

Turn in reference *

Discription of goods *

Number of goods *

Packing

Weight *

UN- Code

number of free days for pick up

Number of free days for turn in

opening times for loading/ unloading

Closing time for loading/ unloading

Attachment 1

Attachment 2

Attachment 3

Attachment 4

Attachment 5

Attachment 6

* = Input is required

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