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UPDATED: 5/7/05
 

CF 3171 Request Form

Please complete the following form IN FULL and submit it to our office.

Name of Agent:

Name of Vessel:

Voyage Number:

IMO Number:

Flag:

Name and Address of Owner:

Arrival Date:

Port of Departure:

Discharge Location(s):

Commodity:

SCAC Code(s):

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