Import declarations

(See Rule 10 of Customs Valuation, 1988) DUPLICATE
Note: This declaration shall not be required for goods imported as passenger's Baggage, goods imported for personal
use up to value of Rs.1000/-, Samples of no commercial value, or where the goods are subject to specific rate of
1. Importer's Name and Address:
2. Supplier's Name and Address:
3. Name and Address of Agent, If Any:
4. Description of Goods:
5. Country Of Origin :
6. Port Of Shipment :
7. AWB/BL Number and Date:
8. IGM Number and Date
9. Contract Number and Date:
10. Nature Of Transaction (Sale, Consignment, Hire, Gift etc
11. Invoice Number and Date:
12. Invoice Value:
13. Terms of payment:
14. Currency of payment
15. Exchange Rate:
16. Terms of Delivery:
17. Relationship between buyer and seller [Rule2(2)]:
18. If related, what is the basis of declared value:
19. Condition or Restrictions attached with the sale [Rule4(2)]:
20. Valuation Method Applicable, (See Rules 4 to 8):
21. Cost and services not included in the invoice value (Rule 9)
(a) Brokerage and commissions:
(b) Cost of containers:
(c) Packing cost:
(d) Cost of goods and services supplied by the buyer:
(e) Royalties and Licence fees:
(f) Value of Proceeds which accrue to seller:
(g) Freight:
(h) Insurance:
(i) Loading, Unloading, handling charges:
(j) Landing charges:
(k) Other payments, if any:
22. Assessable value in Rs.:
23. Previous imports of identical/similar goods, if any:
(a) Bill of Entry Number and Date:
(b) IGM Number and Date:
24. Any other relevant information (Attach separate sheet, if necessary)
1. I/We hereby declare that the information furnished above is true, complete and correct in every respect.
2. I/We also undertake to bring to the notice of proper office any particulars which subsequently come to my/our knowledge which will have
a bearing on valuation.
Date: Signature of Importer
1. Bill Of Entry Number and Date:
2. Valuation Method Applied (See Rules 4 to 8):
3. If Declared Value not accepted, brief reasons:
4. Reference Number and Date of any previous decisions/ruling:
5. Value Assessed:
A.O. Assistant Commissioner
Note: 1. Declaration form in duplicate duly signed by the importer should be attached with original Bill of entry.
2 In case Order-in-Original (Speaking Order) is required, Importer/CHA are requested to apply within 30 days.
No request on this account will be considered after 30 days.

(To be signed by an Importer)

* With C.H.A.

1. I / We declare that contents of invoice (s) No. (s)___________________________ dated_____________
of M/s._____________________________________________________ and or other documents relating to the goods covered by the said invoice (s) and presented herewith are true and correct in every respect.

* OR Without C.H.A.

1. I / We declare that the contents of this bill of entry for goods imported against Bill of Lading No._____________________ dated____________ are in accordance with the invoice No.______________________________________ dated____________ and other documents presented herewith. I/We also declare that the contents of the above mentioned invoice (s) and documents are true and correct in every respect.
2. I / We declare that I / We have not received and do not know of any other documents or information showing a different price, value (including local payments whether as commission or otherwise), quantity or description of the said goods and that if at anytime hereafter, I / We discover any information showing a different state of facts, I / We will immediately make the same known to the Commissioner of Customs.
3. I / We declare that the goods covered by the bill of entry have been imported on an outright purchase / consignment account.
4. I / We am / are not connected with the suppliers / manufacturers as:
(a) Agent / Distributor Indentor / Branch / Subsidiary / Concessionaire and
(b) Collaborator entitled to the use trade marks, patent or design
( c) Otherwise than as ordinary importers or buyers.
5. I / We declare that the method of invoicing has not changed since the date on which my / our books if accounts and/or agreement with the suppliers were examined previously by Custom House (s).

(N.B.:- Strike out whichever is inapplicable)

Signature of Importer


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