(All the fields marked by * are compulsory.)
Importateur ou Receptionaire/Importer :* No du Connaissement/Bill of
lading No. : *
Transitaire/Forwarder : Incoterm :  FOB
 CAF / CIF
 Autre / other
Exportateur ou Declarent/Shipper : * Value de la marchandise/value
of goods : *
Navire/Vessel :* Port de Chargement/
Loading Port : *		 No d'enregistrement/
Registration No. :
ETS : * Port de Dechargement/
Discharging Port : *		 Fait a :
Transporteur/
Carrier : *		 Lieu de Reception/Point
of Origin (*) : *		 Le : *
    Destination Finale/
Final
destination(*) :*		 Cachet et Signature du mandataire stamp and signature of the Rep
Conditionnment / Kind of Package :
Desciption de la Marchandise / Description of goods :*
Nombre Number Poids Brut / Gross Weight (T) : *
  Roulier RORO *
  Conteneur Container *
Volume (M3) :
Sec/Dry Frigo/Reefer
20' Fret Maritime/Ocean Freight
(Unitaire/ Unit) : *
40' Fret Maritime/Sea Freight :
Autre Other Frais de dossier/Handling charges :
Vracs / Bulk
Conventional / General Cargo 		Assurances/Insurance :
THC :
BAF :
Autres charges/Other charges :
Total Fret et Frais :
Fret paye au depart / Prepaid Fret Payable a destination / Freight collected
Lieu et date / Place and date : Le Direceteur General : * Reserve a la Douane
Declaration No. :
Signature et cachet du Declarnat
Signature and stamp of shipper :		 Vu le :
Name : *
Address :
Tel : * Fax : E-mail : *
      
(*) Applicable is B/L Direct / For Through B/L or Combined Transport Only
WHITE - RECEIVER'S COPY
 GREEN - CARRYING LINE'S COPY
BLUE - SHIPPER'S COPY
YELLOW - O.I.C.'S COPY
PINK - O.I.C. AGENCY'S COPY
Instructions on how to issue CTN
1) Importer - The receiver of the goods at West Africa.
2) Forwarder -The forwarder handling the consignment (If applicable).
3) Shipper -The actual shipper of the goods from origin destination.
4) Bill of lading No. -The carrier B/L no.
5) Incoterm -Please tick whether FOE, CAF/CIF or Other.
6) Value of goods -Please type base of the invoice value of the goods.
7) Vessel -Please type vessel name & voyage no.
8) ETS -Please type estimated sailing date.
9) Carrier -Please type the shipping line transporting the goods.
10) Loading port - Please type the port cargo is loaded.
11) Discharge -Please type discharge port at West Africa.
12) Point of origin -Please type cargo receiving point.
13) Final destination -Please type cargo final delivery point.
14) Le: Please type the date of issue of the CTN.
15) Stamp & signature of the Rep - official CTN seal & sign on the seal.
16) Description of goods -Please type accordingly.
17) Kind of package -Please tick accordingly where applicable.
18) Gross weight -Please type accordingly.
19) Volume -Please type if you know, otherwise leave it blank.
20) Ocean freight -Please type freight cost and other applicable charges.
21) Prepaid or collect -Please tick accordingly.
22) Siynature and stamp of shipper-Please make sure the shipper sign & stamp.
23) Le Directeur~ General- The name of the signatory.
24) Reserve a la Douane -To fill the declaration of shipper, just leave it blank if not applicable.