Customer Form USA

Customer Form USA

Hidden
Agent Name
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Agent Email
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Token
Company Details
Company Name*
Company EIN/VAT*
Company Address*
COMPANY ADDRESS CITY STATE ZIP CODE COUNTRY
Company Details
Logistics / Operations
Name of Contact Person – 1*
Name of Contact Person – 2 (Optional)
Designation / Title*
Designation / Title
Mobile Number*
Mobile Number
Office Number
Office Number
Email Address*
Email Address
Accounting / Finance
- Same as Primary Contact
Full Name*
Designation / Title*
Mobile Number*
Office Number
Email Address*
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Signer First name
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Signer Last name
Preferable Invoice Currency*
Insurance
*
- I would like Unicargo to coordinate insurance coverage to all my freight handled by Unicargo.
- I do not want Unicargo to coordinate insurance coverage to all my freight handled by Unicargo.
*
- In case you do not wish purchase insurance for your cargo through Unicargo, it is hereby agreed that you wave subrogation rights against Unicargo.
Terms & Conditions
Terms & Conditions*
- I agree to the terms and conditions published on Unicargo’s Website.