__________  Corporation   _________Partnership  ________Proprietorship  _______Individual

 IRS/EIN #:______________________________________ SSN OR Passport #:__________________________

CFR Line hereafter referred to as CFR is requested and authorized to prepare and issue the necessary Bills of Lading and/or Airway bills, Shipper’s Export Declarations, and any other document required by law, regulation, or shipper’s request on behalf of the undersigned.  CFR is hereby granted full power of attorney to do whatever is required to consign shipments for carriage to destination or for onward carriage and delivery by another transportation organization in accordance with the terms and conditions contained in the Bill of Lading and/or Airway bill, Tariff Rules and Regulations, including provisions thereof, limiting the liability to the shipper’s declared value and/or any such tariff limitations on liability.  If a non-resident Corporation, we further authorize CFR to accept service of process.

Company Name                                                 Signature of duly authorized officer or employee

Street Address/P.O. Box                                       Printed full name

City/State/Postal Code                                       Title

Country                                                                 Date

CFR Line can arrange all-rise insurance covering your exported goods against loss and damage for a standard premium.  Please indicate if this protection is requested     ___yes   ___no