EFTA00558506.pdf

IMPORTER SECURITY FILING (TSF) INFORMATION SHEET Items 1-7 to be completed by shipper/agent & verified by ISF Filer. (1) Seller Name and Address (2) Buyer Name and Address OMBRELLIRCIO ADRIAMARE DI P.GRAZIANI S.N.C. BRICE GORDON (3) Consoidator (Stutter) Name and Address (4) Container Stuffing Location Name and Address CENTRAL SHIPPING AGENCY SPA VIA LuocAnco DI BREME. 27 20156 MILANO CENTRAL SHIPPING AGENCY SPA PAPA GIOVANNI MI, 2 20060 LISCATE ND Per ISF Rule, HTSUS, Country of Origin and Manufacturer must be inked to one another at the line item level. Add additional sheets for addlional HTSUS numbers. (5)Cornmodity,HTSUS Number(s) and Address (6) Country of Origin (7) Manufacturer Name and Address ITALY ELuRCIO ADRIA/AARE DI P.GRAzhvo 5/I.C. I (8) Importer of Record No. (9) Consignee No, To be completed by fonrrardedagent House Bill of Lading Master BAP Vessel Name Voyage No. 11.1007956 (scae code SAIJ) 111560188 (scae code CHOU) ROME EXPRESS 2F183W Date of Departure Port of Departure Container Number Loadng Date 12/21/12 GENOA, ITALY CAXU 97558E/9 12/20/12 ISF Fier Information: DataMme Received ISF Form Received By Date/Time Procees Confirmation # This form must be completed in English and provided to us, no later than 72 hour pnor to sailing. EFTA00558506