The Free Zone, 2315 NW 107th Avenue, BOX 72, Doral, Florida 33172

TEL 305-597-0258 X 106 or 122 / 305-592-0266 FAX

APX Quote # ___________

SHIPPERS SECURITY ENDORSEMENT FORM FOR AIR CARGO ONLY AIRCRAFT

I certify that this cargo does not contain any unauthorized explosives, incendiaries, or hazardous materials, or live persons. I consent to a search of this cargo.  I am aware that this endorsement and original signature, along with other shipping documents, will be retained on file for at least 30 days.

 Shipper’s name: ________________________________________________________________  

 Date: __________________________

 Signature of Shipper or Authorized Representative: ________________________________

 Print name of signatory: _________________________________________________________

 Type of first personal identification reviewed:_______________________________________

 Matching Photo on I.D.  (Gov. issued) indicate Yes or No:  ____________________________

 Numbering appearing on I.D.:  ____________________________________________________  

 Type of second personal identification reviewed: ___________________________________

(If the first one was not a Gov. issued photo I.D. ______________________________________

 Matching photo on I.D. Indicate Yes or No __________________________________________

 Number appearing on I.D. _________________________________________________________  

 Name of I.A.C. employee or authorized representative who verified the I.D. _____________

IMPORTANT: Print and FAX along with PICTURE ID (clear) to 305-592-0266 and send this form via MAIL