SHIPPERS SECURITY ENDORSEMENT

“I CERTIFY THAT THIS CARGO DOES NOT CONTAIN ANY UNAUTHORIZED EXPLOSIVES, INCENDIARIES, OR HAZARDOUS MATERIALS.  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 THIRTY DAYS.”

COMPANY NAME: ________________________________           DATE: ___________________

SIGNATURE OF SHIPPER OR

AUTHORIZED REPRESENTATIVE: _______________________________________________

PRINTED NAME: _________________________________

TYPE OF FIRST PERSONAL

IDENTIFICATION REVIEWED: ______________________

MATCHING PHOTO ON ID? INDICATE:    YES    /    NO

NUMBER APPEARING ON ID: ______________________

TYPE OF SECOND PERSONAL IDENTIFICATION REVIEWED

(IF FIRST WAS NOT A GOVERNMENT ISSUED PHOTO ID): ___________________________

MATCHING PHOTO ON ID?  INDICATE:    YES    /    NO

NUMBER APPEARING ON ID: ______________________

NAME OF PERSON FROM WHOM SHIPMENT WAS

ACCEPTED IF DIFFERENT FROM THE SHIPPER: ___________________________________