Pro Forma Invoice

Shipper Name Consignee Name

Contact person Contact person

Street Address Street Address

City Postal Code City Postal Code

Country Email address Country Email address

Telephone number Fax number Telephone Number Fax number

Tax ID# (EIN) or AES ITN# Exporting Carrier: Tax ID Number (EIN) Incoterms
DHL Express Inc
Other Information. (Gift, Personal Effects, etc.) Total Gross Weight in Kilos DHL Air waybill Number

Country of Quantity, Unit Price Total Price

Complete and Accurate Commodity
HTS/Schedule B Manufacture Unit of USD USD
Description
Measure

I/We hereby certify that the information on this invoice is true Total Price (USD)
and correct and that the contents of this shipment are as stated Insurance Cost (USD)
above. I/We do hereby authorize DHL Express to execute any
Freight Cost (USD)
additional documents necessary for the export of merchandise
described herein on my/our behalf. Total Value (USD)
These commodities, technology, or software were exported
from the United States of America for ultimate destination
in accordance with export
administration regulations. Diversion contrary to U.S. law is
Signature and Title of Authorized Person Date prohibited.