Vehicle Description: Year: Make: Model:
Body Type: V.I.N./Serial No.:

Please Note: No personal effects may be placed in the trunk of the car other than a spare tire and jack.

Cargo Value: $

Please Note: Value must be declared to U.S. Customs if over $2500.

Shipping Details: I will require towing service: Yes No

If Yes, please advise:

Shipper: Phone:

Adress:


Consignee: Phone:

Adress:

If No, please advise:

Name of port to which you will deliver your vehicle:

Final Destination of Vehicle:

Puerto Barrios Puerto Cortes Puerto Limon San Jose Managua

Remarks: