Professional Documents
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Postal Code:
Contact's Title:
Facsimile:
State:
Country:
MID Number:
Is the company public or private? If private, list majority owner(s) (holding over 10% ownership):
Manufacturer
Sea Carrier
Rail
Supplier
Forwarder
Warehouse
Air Carrier
Consolidator
Truck
Other (Specify):
Indicate if your company participates in any of the following programs:
C-TPAT: Customs-Trade Partnership Against Terrorism
NOTE: If your company has already joined C-TPAT, PIP or AEO Security , do not complete this
survey. Instead, indicate the date Customs accepted your company into the program and return
the survey via email to the attention of PROGRAM ACCEPTANCE DATE:
__________
Instructions
1. Answer each question with one of the following answer codes:
The practice or procedure is firmly in place.
2 = Yes
The practice or procedure is partially in place.
1 = Partially
The practice or procedure is not in place.
0 = No
The practice or procedure does not apply to our company.
N/A = Not Applicable.
2. Provide any additional information in the "Comments" box. If additional space is needed to fully
respond, please attach a separate sheet, referring to the section number and question number.
3. Complete a separate questionnaire for each facility.
4. Return the completed questionnaire to the below by e-mail or mail:
E-Mail:
Fax:
Mail:
wendy.himebaugh@federalmogul.com
Federal-Mogul Corporation, 26555 Northwestern Highway, Southfield, MI 48033 USA
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C-TPAT SURVEY
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C-TPAT SURVEY
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C-TPAT SURVEY
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