C-TPAT

Legal Company Name

Year established

Physical address (of production, loading cargo to U.S.)

Number of permanent employees:

Number of Temporary employees:

Hours of operations:

Does the company participate in any of the following security complaince programs?

International Standard Organization (ISO)

Sarbanes Oxley Act (SOX)

Hazard Analysis & Critical Control Points (HACCP)

Other

Main business/commodity:

Main Customers:

Does your company store, produce or transport any of the following:

High value goods

chemicals

Hazardous materials