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LIEFERAVIS

LIEFERAVIS

Return Material Authorization no.

Shipment content*

Senders country*

Senders company name*

Senders street*

Senders PO-Box / country*

Senders contact person

Phone no. Sender

Senders Email-address*

Receivers address*

Receivers contact person

Forwarding agent*

Tracking number

Goods/Contents of shipment

Value of goods of shipment*

Currency*

Net weight of shipment (kg)

Customs tariff number(s) of goods

Manufacturer of goods

KOCH reference / article number*

KOCH Order confirmation number

Reason of shipment*

Further annotations

Data protection*

Yes, I have read the data protection regulations and agree.

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