Fill out your COMPANY LETTER HEAD.

Fill out your COMPANY ADDRESS

LETTER OF INTENT (LOI)

* Company Name: Fill out your company name (mandatory)

DBA:

Business Address

* Address 1: Fill out (mandatory)

* Address 2: Fill out(optional)

* City: Fill out (mandatory)

* State: Fill out (mandatory)

* Zip: Fill out (mandatory)

Business Contact

* Name: Fill out (mandatory)

* Phone: Fill out (mandatory)

* Email: Fill out (mandatory)

Technical Contact

* Name: CyberLogitec America, Inc. It was filled out by Cyberlogitec already

* Phone: 201-291-4730 It was filled out by Cyberlogitec already

* Email: It was filled out by Cyberlogitec already

Self-programmer (If applicable)

* Software Vendor/Service Center Name: Fill out (optional)

* Software Contact Name: Fill out (optional)

* Phone: Fill out (optional)

* Email: Fill out (optional)

Additional Information

Question 1: For which CBP automated system are you submitting your LOI?

Note: A separate LOI is required for each CBP automated system.

Select one then (mandatory)

Automated Broker Interface (ABI)

Sea and Rail Manifest

Air Manifest

ACE Truck Manifest

Other

Question 2: Is your company currently an operational participant or testing in any other CBP automated system? Select one then (mandatory)

YES

NO

If “YES”, select from the following list:

ABI (entry, drawback, in-bond, QP, FTZ, ISF, etc)

Sea and Rail Manifest

Air Manifest

ACE Truck Manifest

Document Image System (DIS) (if selected, must complete the “OTHER” section)

Other :

* Type of Trade Participant Select one more then (mandatory)

Master Vessel Operating Common Carrier (MVOCC)

Non Vessel Operating Common Carrier (NVOCC)

Port Authority

Software Vendor/Service Center

Terminal Operator

Rail Carrier

Other:

* MVOCC/NVOCC/Rail Carrier, please provide your International Carrier Bond

Number: Fill out (If have own)

* MVOCC/NVOCC/Rail Carrier, please provide your Standard Carrier Alpha Code

SCAC: Fill out (mandatory)

* If you are utilizing a service center or port authority, please identify:

It was filled out by Cyberlogitec already

Site Code: 8CLA

* SYSTEM: What data format are you using? It was filled out by Cyberlogitec already

ANSI X.12

CAMIR