Customs Declaration Form of Imported Goods
Pre-input No.: Customs Serial No.:
Import Port:
Filing No.:
Date of Importation:
Date of Declaration:
Operating Agency:
Mode of Transport:
Means of Transport:
B/L No.
Consignee:
Mode of Trade:
Levy or Exemption:
Tax Rate
License No.
Country (Region) of Departure:
Port of Loading:
Domestic Destination:
Approval No.
Mode of Transaction
Freight
Premiums
Sundry Charges
Contract No.
Number of Packages
Kind of Packing
Gross Weight (kg)
Net Weight (kg)
Container No.
Documents Attached
Use
Marks & Nos. and Remarks
Item No. Commodity Code Name&Specification Quantiy&Unit Place of Origin Unit Price Total Price Currency Exemption
Levy of Taxes and Fees
This is to hereby declare that the above declaration items are correct. If any item found false, the application entity will bear the legal liability.
Keyboarder: Recorde Agency:
Declarant:
Unit Address: Application Entity (stamp):
Zip Code: Tel: Date of Filing:
Customs Examination Comment and the Approval Date (stamp should be affixed here)
Form Inspector: Price Inspector:
Tax Collector: Statistician:
Inspector: Approver:
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