Clientdata: Company Private person Company Street Postal code * City * Country * United Kingdom Germany Netherlands Austria Switzerland Italy ------------------------------ Albania Andorra Armenia Azerbaijan Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland Former Yugoslav Republic of Macedonia France Georgia Greece Hungary Iceland Ireland Latvia Liechtenstein Lithuania Luxembourg Malta Moldova Monaco Montenegro Norway Poland Portugal Romania Russia San Marino Serbia Slovakia Slovenia Spain Sweden Turkey Ukraine Vatican City State Title * Mr. Ms. First name * Last name * Phone Fax E-mail * Internet

Transport data: from Country Postal code Place United Kingdom Germany Netherlands Austria Switzerland Italy ------------------------------ Albania Andorra Armenia Azerbaijan Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland Former Yugoslav Republic of Macedonia France Georgia Greece Hungary Iceland Ireland Latvia Liechtenstein Lithuania Luxembourg Malta Moldova Monaco Montenegro Norway Poland Portugal Romania Russia San Marino Serbia Slovakia Slovenia Spain Sweden Turkey Ukraine Vatican City State to Country Postal code Place United Kingdom Germany Netherlands Austria Switzerland Italy ------------------------------ Albania Andorra Armenia Azerbaijan Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland Former Yugoslav Republic of Macedonia France Georgia Greece Hungary Iceland Ireland Latvia Liechtenstein Lithuania Luxembourg Malta Moldova Monaco Montenegro Norway Poland Portugal Romania Russia San Marino Serbia Slovakia Slovenia Spain Sweden Turkey Ukraine Vatican City State

Product -- Please choose product category -- Sanitary products Fresh fruit Fresh meat Milk Metal industry products Wood Mechanical engineering Synthetic materials Glassware, ceramics and construction material Precision instruments Electric and electronic equipment Textiles and clothing Printing industry and publishing products Others Transport Type Dry transport (no temperature control) Transport with temperature control Quantity Measures (LxWxH) (Please write unity) Measures (LxWxH) (Please write unity) Measures (LxWxH) (Please write unity) On pallet Loose Weight (Please write weight) Actual from Message

Binding delivery date Yes No Date Additional transport-assicuration "All risk"? Yes No Transport- value

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