SAMPLE Dock Receipt Form

WITH iQ GL YOU CAN FILL OUT ESSENTIAL SHIPPING DOCUMENTATION ONLINE. UPON YOUR BOOKING YOU WILL RECEIVE AN E-MAIL WITH OUR SHIPPING INSTRUCTIONS. THE SHIPPING INSTRUCTIONS WILL CONTAIN SHIPPING DOCUMENTS GENERATED INDIVIDUALLY FOR YOU. BELOW IS THE FORMAT OF THE DOCUMENT.

IMPORTANT! DO NOT FILE THE FORM BELOW DIRECTLY. WAIT FOR OUR SHIPPING INSTRUCTIONS.

Instructions for filing the DOCK RECEIPT form Before you schedule a pickup for your goods you must:

1. Complete the DOCK RECEIPT form online
2. Submit it to us online (edit and resubmit if any errors in your records appears)
3. Print at least two copies of the DOCK RECEIPT (one for a carrier, second for your records), which will be available in a link sent to you.
4. Fill out missing fields, if any, undersign and hand one copy to an authorized warehouseman or to the driver picking up your freight.
5. Use the bottom or backside of your copy of the document to obtain proofs of acceptance of your freight by the carrier into their possession in writing, including confirmation of description of the freight, number of pieces, name and signature of authorized representative of the carrier or driver.

The DOCK RECEIPT is used by carriers as evidence that your freight was, in fact, received by the carrier for shipment. If your freight is picked up at your door, the inland carrier provides the DOCK RECEIPT to the Freight Forwarder as evidence that satisfactory delivery has been completed. Always keep your copy of DOCK RECEIPT until shipment is complete.

We must receive the completed DOCK RECEIPT from you. Please use the online form or print it and fax to 703-433-0281. Without a DOCK RECEIPT your freight will not be accepted for the international shipment.

All fields with the red asterisk (*) are required and must be filled.

Printed version of the DOCK RECEIPT will look differently, according to the Standard of the Industry.

	S A M P L E     D O C K     R E C E I P T EXPORTER: (Complete Name and Address) BOOKING #* REF#* Export References: Forwarding Agent: Point and country of origin of goods: Domestic routing/Export instructions: Type of Move: OCEAN   AIR   TRUCK Pre-Carriage By: Place of Receipt: Exporting Carrier: Loading Pier/Terminal: Port of Discharge: Port of Loading: Name:* Company: Street address:* City, State, ZIP:* Country:* Phone/Fax:* E-mail:* CONSIGNEE: (Complete Name and Address) Name:* Company: Street address:* City, State, ZIP:* Country:* Phone/Fax:* E-mail: NOTIFY PARTY: (Complete Name and Address) Name: Company: Street address: City, State, ZIP: Country: Phone/Fax: E-mail: Marks and Numbers Pieces* Description of packages and goods* Gross Weight Volume Delivered by: Truck  ____________________ Arrived Date  _______TIME_________ Unloaded Date  _______TIME_________ Checked by  ____________________ Placed in ship on  dock location    Received the above described goods or pkgs subject to all the terms of the undersigned's regular form of dock receipt and bill of lading which shall constitute the contract under which the goods are received, copies of which are available from the carrier on request and may be inspected at any of its offices. For the master: By ______________________________________ Date ____________________________________   I / we hereby certify that the information on this invoice is true and correct and that the contents of this shipment are as stated above. I / we do hereby authorize iQ Global Logistics Corporation to execute any additional documents necessary for export of merchandise described herein on my/our behalf. *I confirm the statement above.