VEHICLE BOOKING FORM

JEMSEL EXPORT LTD

1. ABOUT YOU

Full Name:

UK contact address:

Telephone:

Email:

2. ABOUT THE VEHICLE

Make:

Year of manufacture:

Model:

UK registration number:

Vehicle chassis number:

Vehicle Dimension and Weight if not a saloon car

Length (m):

Width (m):

Weight (Kgs):

Height (m):

3. YOUR OVERSEAS DESTINATION

Name of destination port:

Name of Consignee:

Your overseas contact address:

Telephone:

Other Important Information:

4. DECLARED VALUE OF THE VEHICLE

Date: