Disaster Assistance Export Declaration Form
Submit details for items being exported as disaster assistance. All fields are required to ensure proper declaration and compliance.
Exporter Full Name
*
First Name
Last Name
Exporter Organization Name
*
Exporter Contact Email
*
example@example.com
Exporter Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Destination Country
*
Please Select
Afghanistan
Bangladesh
Haiti
Turkey
Ukraine
Other
Recipient Organization (if applicable)
Description of Items Being Exported
*
Total Quantity of Items
*
Estimated Total Value (USD)
*
Intended Purpose of Export
*
Medical Supplies
Food & Water
Shelter/Construction Materials
Search & Rescue Equipment
Other
Submit Declaration
Should be Empty: