ACE e-Manifest Trip Form

Canada to U.S. only

This is the accessible HTML equivalent of the original ACE e-Manifest Trip Form PDF. The original PDF is not tagged for accessibility.

You may fill in this page and print it using your browser’s Print command. There is no online submission, automatic pricing, or storage of your entries. Follow the email/fax instructions below. Fields marked “required in the original form” correspond to its asterisks.

Instructions

Complete the trip form and fax or email it to GreenLight Services for processing.
Wait for the e-Manifest confirmation to arrive by email or fax.
The driver must present the e-Manifest coversheet confirmation at the time of crossing.

Include invoice documents along with this trip form.
Express filing: $15 additional fee.
Missing, incorrect, or unreadable information may delay processing.
Make multiple copies of this trip form to fax each time you cross into the United States.

A. Company / Carrier Information

Company name

Place the PAPS label on your printed form, or provide the PAPS / SCN number below.

SCAC code

Shipping control number Same as PAPS barcode number

Contact name

Phone number

Fax number

Email Required in the original form

Expected U.S. port of entry Blaine, WA Sweetgrass, MT Portal, ND Port Huron, MI Buffalo, NY Other port

Specify other port

Estimated arrival date MM / DD / YYYY

Estimated arrival time HH:MM, military time (24-hour)

Estimated number of crossings

Crossing frequency Monthly Yearly

B. Shipper Information

Company name and address in Canada where goods will be picked up.

Shipper name

Physical street address

City

State / Province

ZIP / Postal code

Country

C. Consignee Information

Destination in the United States of goods being shipped.

Consignee name

Physical street address

City

State

ZIP code

D. Cargo Details

Please include any invoices associated with this shipment.

Cargo (commodity) description

Does the shipment contain hazardous materials? Yes No

Is this an inbond shipment? Yes No

Total quantity

Unit of measure Cases, crates, boxes, pieces, skids, units, each, etc.

Value ($US)

Total weight (LBS)

Country of origin

E. Vehicle / Truck & Trailer Information

Other truck type

DOT number If applicable

Transponder ID

Truck license plate number

Truck plate state / province

Truck VIN / Serial number Please print

Trailer information (if applicable)

Other trailer type

Trailer license plate number

Trailer plate state / province

F. Driver & Passenger Information

Driver’s full name

Driver’s phone number

Driver license number

Driver license state / province

Is this an enhanced driver license? Yes No

Driver date of birth MM / DD / YYYY

Driver citizenship

Driver gender Male Female

Second form of ID — choose one Passport Birth Certificate US Visa

Driver second ID document number Required in the original form

Driver second ID country / state Required in the original form

Passengers

If there is more than one passenger, provide detailed information for the additional passenger(s) on a separate sheet.

Number of passengers

Passenger first name

Passenger middle initial

Passenger last name

Passenger date of birth MM / DD / YYYY

Passenger citizenship

Passenger gender Male Female

Passenger travel document — choose one Passport Birth Certificate US Visa

Passenger travel document number Required in the original form

Passenger travel document country / state Required in the original form