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DESTINATION CODE

ORIGIN

INTERNATIONAL SHIPMENT
(Non-negotiable)
WAYBILL

Payer account number and shipment value protection details

Charge to

Shipper

Receiver

3rd Party

Cash
Check
Credit Card

Payer Account No.

Shipment Value Protection (see reverse)

Products & Services/Productos y Servicios

Domestic

Yes Declared Value for Carriage (in US $)

Not all payment


options are available
in all countries.

International
Document

International
Non-Document

Products (not all are available to and from all locations)

EXPRESS 9:00
EXPRESS 10:00

EXPRESS 12:00

From (shipper)

EXPRESS / WORLDWIDE

Shippers Account Number

Contact Name

ECONOMY SELECT

4
Shippers Reference (up to 35 characters)

EXPRESS ENVELOPE

Shipment Details

Total number of
packages

OTHER

Total Weight
if DHL Express Document
packaging used, enter XD

Dimensions (in inches)


Length
Width
Height

Pieces

Company Name

Non standard Pickup

Delivery Notification

Payable Packaging

@
Globalmail Business

Priority

Full Description of Contents

Standard

Other

DIMENSIONAL/CHARGEABLE WEIGHT

Give Content and Quantity

lbs

Phone, Fax, or E-mail (required)

6
3

Saturday Delivery
Other

Address

Post/ZIP Code (required)

Optional Services (extra charges may apply)

Dutiable Shipments Only (Customs requirement)

SERVICES

CHARGES

Drop Box #

TOTAL

Attach the original and four copies of a Proforma or Commercial Invoice.


Export License No./Symbol (if applicable)
Receivers VAT/GST or Shippers EIN/SSN

To (Receiver)

Company Name
Declared Value for Customs (in US $)

Schedule B Number/Harmonized Code (if applicable)

AES TRANSACTION NUMBER

TYPE OF EXPORT
Permanent
Repair/Return

(as on commercial/proforma invoice)

Airway Bill

Contact Person

Delivery Address Cannot Deliver to a PO Box

Temporary

Destination Duties/Taxes If left blank, Receiver pays duties/taxes.


Receiver
Shipper
Other

TRANSPORT COLLECT STICKER No.

Specify approved account number

The commodities, technology or software to be exported from the U.S. are in compliance with the
U.S.Bureau of Export Administration. Diversion to countries contrary to U.S. law prohibited.

Country

7
Post/ZIP Code (required)

Phone, Fax, or E-mail (required)

No.:
Type

Shipper's Authorization (signature required)

Expires

Auth.

I/we agree that DHLs standard terms apply to this shipment and limit DHLs liability for loss or
damage to U.S. $100. The Warsaw Convention May also apply (see reverse). I/We authorize DHL to
complete other documents necessary to export this shipment. I/we understand that Shipment Value
Protection is available on request, for an extra charge. I/we agree to pay all charges if the recipient or
3rd party refuses to pay. I/we understand that DHL DOES NOT TRANSPORT CASH.
Signature (required)

PAYMENT DETAILS (Check, Card No.)

Date

PICKED UP BY
Route No.
Time

Date

OUP: this may be reproduced for class use solely for the purchaser's institute

Process and Track your shipment online: