NOTE
DECLARATION FORM
(See Rule 10 of Customs Valuation Rules 1988)
: This Declaration shall not be required for goods imported as passenger's Baggage, goods, imported for personal
use upto Value Rs. 10001- samples of no commercial value or where the goods are subject to specific rate of duty.
Importer's Name and address:
2
Supplier's Name and address:
3
Name and address of the agent, if any:
4
Description of goods:
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Country of origion :
Port of shipment:
AWBI BL Number and date
IGM Number and date:
Contract number and date:
Nature of transaction (sale, consignment, hire, gift, etc.)
Invoice number and date:
Invoice value:
22.
23.
Terms of payment:
Currency of payment:
Exchange rate:
Terms of delivery
Relationship between buyer and seller [Rule 2(2)]
If related, what is the basis of deClarevalue:
Conditions or restriction attached with the sale [RULE 4(2)]
Valuation method application (See Rule 4 to 8)
Cost and services not included in the invoice value (Rule9)
(a) Brokerage and Commissions:
(b) Cost of containers:
(c) Packing cost:
(d) Cost of goods and services supplied by the buyer:
(e) Royalties and licencefees:
(f) Value of proceeds which accure to seller:
(g) Freight:
(h) Insurance:
(i) Loading, Unloading, handling charges:
U) Landing charges:
(k) Other payments, if any:
Assessable value Rs. :
Previous imports of identical 1similar goods, if any:
(a) Bill of Entry Number and date:
(b) IGM Number and date:
Any other relevant information (attach separate sheet, if necessary) :
DECLARATION
I/We hereby declare that the information furnished above is true, completed & correct in every respect.
I/We also undertake to bring to the notice of proper officer any particulars which subsequently come to my1
our knowledge which will have a bearing on valuation.
24.
Place:
Date:
FOR CUSTOMS HOUSE USE:
1. Bill of Entry Number and Date:
2. Valuation Methods applied (See Rules 4 to 8) :
3. If declared value not accepted, brief reasons:
4. Reference number and date of any previous decision / ruling:
5. Value assessed: A.a. Assistant Collector. .
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.
Signature of Importer