WHLC039DX33161

K/D WOODEN FURNITURE HS CODE= 940360 PO#LHLENWH-378 379 SHIPPER DECLARED= THIS SHIPMENT CONTAINS NO SOLID WOOD PACKING MATERIALS TSCA TITLE VI COMPLIANT I CERTIFY THAT ALL CHEMICAL SUBSTANCES IN THIS SHIPMENT COMPLY WITH ALLAPPLICABLE RULES OR ORDERS UNDER TSCA AND TH AT I AM NOT OFFERING A CHEMICAL SUBSTANCE FOR ENTRY IN VIOLATION OF TSCA OR ANY APPLICABLE RULE OR ORDER THEREUNDER. SHIPPINGDOCS@SAM SONMKTG.COM EMAILS= SAMINLT@ANDERINGER.COM, JQUINTO@ANDERINGER.COM, MBERMEJO@ANDERINGER. COM 2ND NOTIFY PARTY= SAMSON MARKETING C/O LEGACY CLASSIC FURNITURE 2575 PENNY ROAD HIGH POINT, NC 27265 TELEPHONE= (336) 899-2142 FAX = (336) 899-2147 CONTACT= JAVIER COLMENARES E= JCOLMENARES@SAMSONMKTG.COM, SHIPPINGDOCS@ SAMSONMKTG.COM LEGACY CLASSIC FURNITURE 815 VISIONARY STREET, LENOIR, NC 28645 CONTACT= MICHELE WIGLESWORTH TEL= (336) 822-8824K/D WOODEN FURNITURE HS CODE= 940360 PO#LHLENWH-378 379 SHIPPER DECLARED= THIS SHIPMENT CONTAINS NO SOLID WOOD PACKING MATERIALS TSCA TITLE VI COMPLIANT I CERTIFY THAT ALL CHEMICAL SUBSTANCES IN THIS SHIPMENT COMPLY WITH ALLAPPLICABLE RULES OR ORDERS UNDER TSCA AND TH AT I AM NOT OFFERING A CHEMICAL SUBSTANCE FOR ENTRY IN VIOLATION OF TSCA OR ANY APPLICABLE RULE OR ORDER THEREUNDER. SHIPPINGDOCS@SAM SONMKTG.COM EMAILS= SAMINLT@ANDERINGER.COM, JQUINTO@ANDERINGER.COM, MBERMEJO@ANDERINGER. COM 2ND NOTIFY PARTY= SAMSON MARKETING C/O LEGACY CLASSIC FURNITURE 2575 PENNY ROAD HIGH POINT, NC 27265 TELEPHONE= (336) 899-2142 FAX = (336) 899-2147 CONTACT= JAVIER COLMENARES E= JCOLMENARES@SAMSONMKTG.COM, SHIPPINGDOCS@ SAMSONMKTG.COM LEGACY CLASSIC FURNITURE 815 VISIONARY STREET, LENOIR, NC 28645 CONTACT= MICHELE WIGLESWORTH TEL= (336) 822-8824

A N Deringer

19520 WILMINGTON AVE RANCHO DOMING UEZ CA 90220 TEL= 1-424-296-3373 C ONTACT= MARIA BERMEJO-SANCHEZ]]