| ltrlOwnerSignature |
| ____________________ |
Survey Summary |
| ltrlShipperName: | XXShipperNameYY | |
| ltrlSurveyDate: | XXSurveyDateYY | |
| ltrlOriginAddress: | XXOriginAddressYY | XXOriginDescriptionYY |
| ltrlDestinationAddress: | XXDeliveryAddressYY | XXDeliveryDescriptionYY |
|
|
| Description | Qnt. | ltrlVolume | ltrlWeight | Comment | Room | ||||||||||||||||||||
| XXCommentsYY |
| ltrlOwnerSignature |
| ____________________ |