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SED Form


Create Shipper's Export Declaration

The government requires that this document be printed on goldenrod paper.

U.S. Principal Party in Interest (USPPI)
Name:  
Address:  
City:  
Country/Territory:
State/Province:  
Postal Code:    
Contact Telephone:
Contact E-Mail:
USPPI EIN (IRS) or ID No.  
Parties to Transaction:  

Ultimate Consignee
Name:  
Address:  
City:  
Country/Territory:
State/Province:
Postal Code:

Intermediate Consignee
Name:
Address:
City:
Country/Territory:
State/Province:
Postal Code:

Shipment Information
Transportation Reference Number: Leave blank to automatically create.
Date of Exportation:
Point (State) of Origin or FTZ No.:  
Country of Ultimate Destination  
Loading Pier:  
Method of Transportation:  
Exporting Carrier:  
Port of Export:  
Port of Unloading:  
Containerized:
Carrier Identification Code:
Shipment Reference Number:
Entry Number:
In Bond Code:
Hazardous materials:
Routed Export Transaction:

If additional item space is necessary to complete this form, please enter the number below:
Number of additional items:   

Description
D/F/M Scd B Number Description Quantity Shipping Weight
(KILOS)
VIN/
Product Number
Value (USD
omit cents)
           
 

Authorization
Validated License Number Enter Number or NLR
ECCN
Authorized Officer or Emp.  
The exporter authorizes the forwarder named above to act as forwarding agent for export control and customs purposes.

Terms and Conditions
Terms and Conditions


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