Thuan Quan

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EXPRESS WORLDWIDE

2023-09-04 MYDHL+ 1.0 / *30-0821*


WPX
From : CV JAWADWIPA NUSANTARA Origin:
M ARI FIRDAUS
DSN PELEM RT 002 RW 002 DESA MAESAN
KECAMATAN MOJO
SUB
64162 KEDIRI EAST JAVA
Indonesia

To : Thuan Quan Contact:


Thuan Quan
Thuan Quan
1502 Springaire Ln

75077 LEWISVILLE Texas


United States of America

. US-COP-FTW
Day Time
.
C-ADI
Pce/Shpt Weight Piece
Ref:
0.5 kg 1 / 1

Contents: Custom
personal ized sneaker

WAYBILL 49 0611 4113

(2L)US75077+48000001

(J) JD01 4600 0111 5822 7716


*WAYBILL DOC*
Not to be attached to package - Hand to Courier
2023-09-04 MYDHL+ /
WPX
Shipper :
Contact:
CV JAWADWIPA NUSANTARA +6282235021225
M ARI FIRDAUS
DSN PELEM RT 002 RW 002 DESA MAESAN
KECAMATAN MOJO
64162 KEDIRI EAST JAVA
Indonesia

Receiver : Contact:
Thuan Quan Thuan Quan
Thuan Quan +19726973506
thuanquan@ymail.com
1502 Springaire Ln
75077 LEWISVILLE Texas
United States of America

. ID-SUB-KQR US-COP-FTW .
Product Details: Features / Services (Service Code)

[P] EXPRESS WORLDWIDE (48) Automated Digital Imaging(PJ)


Payer Details Emergency Situation(CR)
Freight A/C: 548921920
Duty A/C: Receiver Will Pay
Taxes A/C: Receiver Will Pay

Shipment Details
Ref:
Custom Val: 100.00 USD
Cust Decl Shpt Wgt (UOM) / Dim Wgt (UOM): Pieces

0.5 kg 1
Name (in Capital Letters) Signature Date (DD.MM.YYYY)

Contents: Custom
personal ized
sneaker

WAYBILL 49 0611 4113


License Plates of pieces in shipment
JD014600011158227716

- page 1 of 1 -
Proforma Invoice
AWB No: 4906114113 Invoice Date: 2023-09-04 Invoice No:

SHIP FROM: SHIP TO:


CV JAWADWIPA NUSANTARA Thuan Quan
M ARI FIRDAUS Thuan Quan
DSN PELEM RT 002 RW 002 DESA MAESAN 1502 Springaire Ln
KECAMATAN MOJO

KEDIRI, 64162 LEWISVILLE, 75077


EAST JAVA Texas
Indonesia United States of America
+6282235021225 +19726973506
cvjawadwipanusantara@gmail.com thuanquan@ymail.com
Trader Type:PRIVATE Trader Type:PRIVATE
VAT No: VAT No:
EORI: EORI:
TAX ID:

Shipper Reference:
Receiver Reference:

Remarks: Custom personalized sneaker

C o m m o - Tax Item Weight/ Sub Total


Item Description Item Total
COO Reference Type & QTY Unit
dity Code Paid Weight ID Value Value

1 Custom personalized sneaker 0.100 kg INDONESIA 1.00 PCS 100.00 100.00


0.100 kg USD USD

Total Goods Value: 100.00 USD Total line items: 1


Total Invoice Amount: 100.00 USD Number of Pallets:
Currency Code: USD Total units: 1.0
Terms of Payment: Package Marks / Other Info:
Terms of Trade: Delivered at Place
Place of Incoterm:
Reason for Export: Personal, Not for Resale
Type of Export: Personal Belongings/Not for Resale
Total Net Weight: 0.100kg Payer of GST / VAT:
Total Gross Weight: 0.500kg Duty / taxes acct: Receiver Will Pay
Requiere Pedimento: No
Duty / tax billing service:
Carrier: DHL
Ultimate Consignee:
Exemption Citation:

I/We hereby certify that the information contained in the invoice is true and correct and that the contents of this shipment are as stated above.

Name: Signature: Company Stamp


Position:
Date of Signature: 2023-09-04
Page 1 of 1

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