Adobe Scan 22 Jul 2024

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CITY-LINK

Express

960307113105155

Origin Station Destination Station


BSP KKM
1. From (Shipper) 6. Ship To (Receiver)
Contact Person Phone Number Contact Person Phone Number
CHAN KAM MIN NORSYAFINAZ
0124080443 0351248118
Shipper / Company Name Consignee Name
CHAN KAM MIN OFT CHEMICAL SDN BHD
Shipper Address Receiver Address(We Do Not Deliver to P.O.Box)
20 JALAN BP5/10 NO,74 JALAN TAMBUR 33/19
BANDAR BUKIT PUCHONG SHAH ALAM TECHNOLOGY PARK
SECTION 33

City State / Province City State / Province


PUCHONG SELANGOR SHAH ALAM SELANGOR
Country ZIP/Postal Code Country ZIP / Postal Code
MY 47120 MY 40400

Shipper's Account No Shipper's Reference No Receiver's Account No Receiver's Reference No

2. Shipper's Signature &Authorization 7. Receiver's Signature & Authorization


Shipper's Signature Date (DD/MMYYYY) Receiver's Name
22/07/2024

Time (HH/MM) Date (DDIMMYYYY) Time (HH/MM)

|3. Services Receiver's Signature


Product Group Product Type Receiver's ID No.
DOX
4. Shipment Information
No. of Pieces Gross Weight (kg) Chargeable Weight (kg)
1 0.16 0.16
Country Of Manufacture
|Descriptionof Goods / Harmonized Code Custom Value
Currency
Sender's VAT/GST No
Receiver's VATIGST No
5. Transportation Charges 8. Duties and Taxes
D BillShipper A/C No: DBill Shipper
D Bill Receiver A/C No:
BillReceiver
Default to Shipper Account If Not Selected Default to Receiver If Not Selected

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