Philippine Based Client Application Form

* fields in bold are required.
Name
Email Address
Contact No.	Area code	Phone Number
Home
Mobile
Work
Date of Birth (must be 21yrs old & above)
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Billing Address
Delivery Address
NOTE: Billing address should be the same as the billing address of your credit card.
Average Shipment per month:			12345678910
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Remarks
Press Down to see the rest of the liability limitation and terms of the agreement.
LIABILITY LIMITATIONS Manila Forwarder shipments are insured for up to $200 per package. Additional insurance is available for five dollars for every one hundred dollar value over the two hundred dollars that is included in your payment. Insurance companies do not cover claims against breakage. You can however protect your shipment by crating it or pay us to do the crating service for you for one hundred dollars fee per item. I believe that the shipment is properly packed, and like most major airlines and transportation companies, Manila Forwarder and its agents will not be liable for any type of damage to your shipment. I am responsible for packaging items securely. Shipping breakable items is not recommended, and doing so is at my own risk of damage. For security and legal reasons, items are subject to search, and illegal or potentially unsafe property and prohibited commodities are subject to seizure. To facilitate this, my shipment may not be locked. If I do lock my package, it may cause a delay in my shipment. Further, the lock will need to be removed, and I am attaching the key to the package itself, which may cause damage to your package for which Manila Forwarder and/ or other law enforcement agencies will not be liable. A commercial invoice is required for customs purposes for international services along with additional FAA, US Homeland Security, and Philippine Bureau of Customs documents that may be required for security purposes. I understand that Manila Forwarder and its agents' liability is limited to $200 unless extra insurance is obtained to which amount $______ and premium of $ _______ was paid. Manila Forwarder and its agents will not be liable for the loss of or physical damage to certain packages, including but not limited to, jewelry, electronic equipment, personal keepsakes, antiques, art, fragile items (including glass), unique or one-of-a-kind items or items of unusual value (including, but not limited to, precious metals, or currency). Such items are shipped expressly at my own exclusive risk.
If you accept the Liability Limitation, click the checkbox
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