From: 919845209359

Akshay Tiwary

Origin ID: BLRB

No.96, 8th Main

M.S Ramaiah City, J. P Nagar 8th Ph
Bangalore, KA 560078
INDIA
SHIP TO: (608) 262-3961

Ship Date: 13FEB15

ActWgt: 0.5 KG
CAD: 105912128/WSXI2900

J151015011404uv

BILL SENDER

Office of Admissions and Recruitmen

University of Wisconsin-Madison
702 West Johnson Street, Suite 1101
Madison, WI 53715-1007

REF: FedEx Student offer. Collect INR 1090.00

DESC-1: Documents only - University Application Forms
DESC-2:
DESC-3:
DESC-4:
COUNTRY MFG: IN
CARRIAGE VALUE:
T/C: S *********
SIGN: Akshay Tiwary
EIN/VAT:
PKG TYPE: ENV

D/T: R

Madison, WI 53715
US
TRK#
0430

7802 0134 3341

XH MSNA
For all commodities, technology or software previously exported from the United States, this was
done in accordance with the Export Administration Regulations. Diversion of these items contrary to
U.S. law or any other applicable country's law is prohibited.

CONSIGNEE COPY- PLEASE PLACE IN FRONT OF POUCH

537J1/A1B3/EE4B

10:30A
INTL PRIORITY

53715
WI-US

MSN

From: 919845209359
Akshay Tiwary

Origin ID: BLRB

No.96, 8th Main

M.S Ramaiah City, J. P Nagar 8th Ph
Bangalore, KA 560078
INDIA
SHIP TO: (608) 262-3961

Ship Date: 13FEB15

ActWgt: 0.5 KG
CAD: 105912128/WSXI2900

J151015011404uv

BILL SENDER

Office of Admissions and Recruitmen

University of Wisconsin-Madison
702 West Johnson Street, Suite 1101
Madison, WI 53715-1007

REF: FedEx Student offer. Collect INR 1090.00

DESC-1: Documents only - University Application Forms
DESC-2:
DESC-3:
DESC-4:
COUNTRY MFG: IN
CARRIAGE VALUE:
T/C: S *********
SIGN: Akshay Tiwary
EIN/VAT:
PKG TYPE: ENV

D/T: R

Madison, WI 53715
US
TRK#
0430

7802 0134 3341

XH MSNA
For all commodities, technology or software previously exported from the United States, this was
done in accordance with the Export Administration Regulations. Diversion of these items contrary to
U.S. law or any other applicable country's law is prohibited.

CONSIGNEE COPY- PLEASE PLACE IN FRONT OF POUCH

537J1/A1B3/EE4B

10:30A
INTL PRIORITY

53715
WI-US

MSN

From: 919845209359
Akshay Tiwary

Origin ID: BLRB

No.96, 8th Main

M.S Ramaiah City, J. P Nagar 8th Ph
Bangalore, KA 560078
INDIA
SHIP TO: (608) 262-3961

Ship Date: 13FEB15

ActWgt: 0.5 KG
CAD: 105912128/WSXI2900

J151015011404uv

BILL SENDER

Office of Admissions and Recruitmen

University of Wisconsin-Madison
702 West Johnson Street, Suite 1101
Madison, WI 53715-1007

REF: FedEx Student offer. Collect INR 1090.00

DESC-1: Documents only - University Application Forms
DESC-2:
DESC-3:
DESC-4:
COUNTRY MFG: IN
CARRIAGE VALUE:
T/C: S *********
SIGN: Akshay Tiwary
EIN/VAT:
PKG TYPE: ENV

D/T: R

Madison, WI 53715
US
TRK#
0430

7802 0134 3341

XH MSNA
For all commodities, technology or software previously exported from the United States, this was
done in accordance with the Export Administration Regulations. Diversion of these items contrary to
U.S. law or any other applicable country's law is prohibited.

CONSIGNEE COPY- PLEASE PLACE IN FRONT OF POUCH

537J1/A1B3/EE4B

10:30A
INTL PRIORITY

53715
WI-US

MSN

From: 919845209359
Akshay Tiwary

Origin ID: BLRB

No.96, 8th Main

M.S Ramaiah City, J. P Nagar 8th Ph
Bangalore, KA 560078
INDIA
SHIP TO: (608) 262-3961

Ship Date: 13FEB15

ActWgt: 0.5 KG
CAD: 105912128/WSXI2900

J151015011404uv

BILL SENDER

Office of Admissions and Recruitmen

University of Wisconsin-Madison
702 West Johnson Street, Suite 1101
Madison, WI 53715-1007

REF: FedEx Student offer. Collect INR 1090.00

DESC-1: Documents only - University Application Forms
DESC-2:
DESC-3:
DESC-4:
COUNTRY MFG: IN
CARRIAGE VALUE:
T/C: S *********
SIGN: Akshay Tiwary
EIN/VAT:
PKG TYPE: ENV

D/T: R

Madison, WI 53715
US
TRK#
0430

7802 0134 3341

XH MSNA
For all commodities, technology or software previously exported from the United States, this was
done in accordance with the Export Administration Regulations. Diversion of these items contrary to
U.S. law or any other applicable country's law is prohibited.

CONSIGNEE COPY- PLEASE PLACE IN FRONT OF POUCH

537J1/A1B3/EE4B

10:30A
INTL PRIORITY

53715
WI-US

MSN

From: 919845209359
Akshay Tiwary

Origin ID: BLRB

No.96, 8th Main

M.S Ramaiah City, J. P Nagar 8th Ph
Bangalore, KA 560078
INDIA
SHIP TO: (608) 262-3961

Ship Date: 13FEB15

ActWgt: 0.5 KG
CAD: 105912128/WSXI2900

J151015011404uv

BILL SENDER

Office of Admissions and Recruitmen

University of Wisconsin-Madison
702 West Johnson Street, Suite 1101
Madison, WI 53715-1007

REF: FedEx Student offer. Collect INR 1090.00

DESC-1: Documents only - University Application Forms
DESC-2:
DESC-3:
DESC-4:
COUNTRY MFG: IN
CARRIAGE VALUE:
T/C: S *********
SIGN: Akshay Tiwary
EIN/VAT:
PKG TYPE: ENV

D/T: R

Madison, WI 53715
US
TRK#
0430

7802 0134 3341

XH MSNA
For all commodities, technology or software previously exported from the United States, this was
done in accordance with the Export Administration Regulations. Diversion of these items contrary to
U.S. law or any other applicable country's law is prohibited.

CONSIGNEE COPY- PLEASE PLACE IN FRONT OF POUCH

537J1/A1B3/EE4B

10:30A
INTL PRIORITY

53715
WI-US

MSN