Port Code SB No SB Date

INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21

CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - I - SHIPPING BILL SUMMARY

[Link] [Link] [Link] [Link] [Link] [Link] [Link] [Link]/DFIA [Link] [Link]-EXP [Link]
STATUS

SEA N Y N Y Y N N Y Y
A

[Link] OF LOADING INCOK1 (Cochin) [Link] OF FINALDESTINATION UNITED ARAB EMIRATES

[Link] OF ORIGIN KERALA [Link] OF FINAL DESTINATION AEJEA (Jebel Ali)

PY
[Link] OF DISCHARGEAEJEA (Jebel Ali) [Link] OF DISCHARGE UNITED ARAB EMIRATES
[Link]'S NAME & ADDRESS [Link] NAME & ADDRESS
ALSAM EXPORT & IMPORT HEBRON GENERAL TRADING LLC
B DECLARAN

KMC36/1975,EP8/572,12 MURI NAGAR31 SHEIKH MHARA BUILDING, 3RD FLOOR

DETAILS

1,PAZHAYATTINKUZHI, THATTAMALA P.O 310, AL QUSAIS 2 DUBAI- UNITED ARAB EMIRATES

CO
KOLLAM,KERALA [Link] Private AE
3. AD CODE: 6393198 8. GSTIN / TYPE 32BPSPN8033E1ZS GSN
[Link] WAIVER NO.& DT [Link] BANK A/C NO. 24XXXXXXX105
[Link] NAME NEO LOGISTICS [Link] BANK A/C NO. 24XXXXXXX105
[Link] 11. IFSC NO. ICIC0002487
[Link] VALUE [Link] [Link] [Link] [Link] [Link] CLAIM 2. IGST AMT [Link] AMT
SUMMA
E MANIFEST [Link]

[Link].
89816.48 1489 0 0 0 55

D.
[Link] 7.P/C [Link] [Link] [Link] VALUE [Link] AMT
RT
0 0 450
[Link] NO. [Link] DT [Link] NO. [Link] DT N.O.C. [Link] [Link] NO. 3. INV AMT. [Link]
DETAILS

1 [Link]-01 1226.4 USD

SUMMARY
PO

[Link] [Link] [Link] 4.S No [Link] [Link] NO [Link] DT [Link]

CHALLAN DETAILS
G. EQUIPMENT
DETAILS

EX

H
T

[Link] TYPE [Link] OF CARGO [Link]. OF PACKETS [Link]. OF CONTAINERS [Link] PACKETS
I. ANNEX
DETAILS

WAREHOUSE SEALED CONTAINERISED 126 0 0

LE

[Link] & NUMBERS I/WE UNDERTAKE TO ABIDE BY THE PROVISIONS OF FOREIGN EXCHANGE MANAGEMENT ACT, 1999,
AS AMENDED FROM TIME TO TIME, INCLUDING REALISATION OR REPATRIATION OF FOREIGN
EXCHANGE TO OR FROM INDIA.

[Link] [Link] [Link] [Link] NO. 2/72

[Link]

[Link] 30-APR-21 12:11 [Link] Date. 30-APR-21

DETAILS

[Link] 30-APR-21 00:00 [Link] Realisation Date 31-JAN-22

[Link] 30-APR-21 00:00
[Link] 30-APR-21 15:29

Signature Not Verified

Digitally signed by DS CENTRAL BOARD
OF INDIRECT TAXES AND CUSTOMS 04
Date: 2021.04.30 [Link] IST
Reason: CUSTOMS
NOTE : The RoDTEP amount indicated in the shipping bill is only NOTIONAL. Location: INDIA
Glossary
A: ASSESS - Assessed, EXMN - Examined, MEIS - Merchantise Export Incentive Scheme, DBK - Drawback, ROSL - Rebate of State Levies,
DEEC - Duty Exemption Entitlement Certificate, DFRC - Duty Free Replenishment Certificate,LUT - Letter of Under Taking. B: CB - Customs Broker
AD Authoized Dealer , AEO - Authorized Economic Operator, UCR - Unique Customs Reference C: DISCOU - Discount, COM - Commission,
P/C Packing Charges,D: EX. PR.- Export Promotions E: MAWB / HAWB - Master / House Airway Bill Number J:BRC- Bank Realisation Certificate

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Page 1 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - II - INVOICE DETAILS

[Link] [Link] No. & Dt. [Link]. & Dt. [Link] No. & Dt [Link] No.&Dt [Link] code [Link]
REF
A.

1 EX-01 29/04/2021 HGT/4/29 6393198 CF

[Link]'S NAME & ADDRESS [Link]'S NAME & ADDRESS
ALSAM EXPORT & IMPORT HEBRON GENERAL TRADING LLC

Y
KMC36/1975,EP8/572,12 MURI NAGAR31 SHEIKH MHARA BUILDING, 3RD FLOOR
B. TRANSACTION

1,PAZHAYATTINKUZHI, THATTAMALA P.O 310, AL QUSAIS 2

PARTIES

691020 DUBAI- UNITED ARAB EMIRATES

OP
[Link] PARTY NAME & ADDRESS [Link] AEO STATUS

[Link] VALUE

TC
[Link] VALUE 3FREIGHT [Link] [Link] 8.P/C [Link] RATE
[Link]
DTLS

1226.4 1206.4 20 0 0 0 0 1 USD INR 74.45

USD USD USD
[Link] [Link] CD [Link] [Link] [Link] [Link] [Link](F/C)
1 17049030 40 CTN ALMOND SOAN PAPDI ( LUT ARN NO:AD 259.8 KGS 1.93995 504
320421006472S )
OR
2 17049030 9 CTN MYSORE CANDY ( LUT ARN NO:AD320421 38.72 KGS 1.95248 75.6
006472S )
3 17049030 46 CTN SOAN PAPDI ( LUT ARN NO: AD320421 188.74 KGS 2.04726 386.4
006472S )
4 17049030 12 CTN LEMON CANDY ( LUT ARN NO:AD320421 42.14 KGS 2.39203 100.8
006472S )
5 17049030 11 CTN BURFI ( LUT ARN NO:AD320421006472 S ) 78.55 KGS 1.17632 92.4
6 17049030 8 CTN MIXTURE CANDY ( LUT ARN NO:AD32042 45.46 KGS 1.47822 67.2
XP

1006472S )
TE
D. ITEM DETAILS

LE

Glossary
A: Ref - Reference P.O. - Purchase Order, LoC - Letter of Credit, AD - Authorised Dealer C: VAL DTLS - Valuation Details
FOB - Freight On Board, DEDUCT - Deduction , P/C - Packing Charge D: HS CD - Harmonized System Code, UQC - Unit Quantity Code

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Page 2 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - III - ITEM DETAILS

1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 1 17049030 40 CTN ALMOND SOAN PAPDI ( 259.8 KGS 1.93995 504 36910.88 158.87
LUT ARN NO:AD
320421006472S )
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD

PY
Y LUT 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 259.8 KGS KERALA KOLLAM
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

CO
1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 2 17049030 9 CTN MYSORE CANDY ( LUT 38.72 KGS 1.95248 75.6 5536.63 159.9
ARN NO:AD320421 006472S )
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y LUT 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
RT
Drawback 38.72 KGS KERALA KOLLAM
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
PO

1 3 17049030 46 CTN SOAN PAPDI ( LUT ARN 188.74 KGS 2.04726 386.4 28298.34 167.66
NO: AD320421 006472S )
INVOICE (1/1)

[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y LUT 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 188.74 KGS KERALA KOLLAM
EX

24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 4 17049030 12 CTN LEMON CANDY ( LUT 42.14 KGS 2.39203 100.8 7382.18 195.9
ARN NO:AD320421 006472S )
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
T

Y LUT 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
LE

Drawback 42.14 KGS KERALA KOLLAM

24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 5 17049030 11 CTN BURFI ( LUT ARN 78.55 KGS 1.17632 92.4 6767 96.33
NO:AD320421006472 S )
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y LUT 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 78.55 KGS KERALA KOLLAM
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

GLOSSARY
FOB - Freight On Board, HS CD Harmonized System Code, UQC - Unit Quantity Code, PMV - Present Market Value, CESAM - Cess Amount
IGSTSTA - IGST Payment Status, VAL - IGST Value, PAID - IGST Amount Paid, SCHCOD - Scheme Code, SQC MSR - Standard Quantity
Measurement, comp - compensatory, PT Abroad - Preferential treatment Availed Abroad

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Page 3 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - III - ITEM DETAILS

1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 6 17049030 8 CTN MIXTURE CANDY ( LUT 45.46 KGS 1.47822 67.2 4921.45 121.06
ARN NO:AD32042 1006472S )
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y LUT 19

PY
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 45.46 KGS KERALA KOLLAM
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

CO
RT
PO
INVOICE (1/1)

T EX
LE

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Page 4 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - IV - EXPORT SCHEME DETAILS

A. DRAWBACK & ROSL CLAIM

[Link] SNO [Link] SNO [Link] SNO. [Link]/WT [Link] [Link] [Link] AMT [Link] [Link]+ROSL
1 1 1704B 259.8 36910.88 .15 55.37
1 2 1704B 38.72 5536.63 .15 0
1 3 1704B 188.74 28298.34 .15 0
1 4 1704B 42.14 7382.18 .15 0

Y
1 5 1704B 78.55 6767 .15 0
1 6 1704B 45.46 4921.45 .15 0
B. AA / DFIA LICENCE DETAILS

OP
[Link] SNO [Link] SNO [Link] NO [Link] OF EXPORT ITEM [Link] SNO [Link] [Link] [Link] VALUE
[Link] [Link] OF IMPORT ITEM 11IMP SNO 12IMPQT [Link] [Link] / IMP

TC C. JOBBING DETAILS
[Link] NO [Link] DATE [Link] CODE [Link] OF IMPORTED GOODS [Link] IMP [Link] USED

D. SINGLE WINDOW DECLARATION

[Link] [Link] [Link] [Link] [Link] CD [Link] TEXT [Link] MSR [Link]
OTHER ADDITIONAL INFORMATION

1 1 CHR SQC 259.8 KGS

OR

1 1 DTY GCESS 0 INR

1 1 DTY RDT RODTEPY Claimed 259.8 KGS
1 1 ORC DOO 559
1 1 ORC EPT NCPTI
1 1 ORC STO 32
1 2 CHR SQC 38.72 KGS
XP

1 2 DTY GCESS 0 INR

1 2 DTY RDT RODTEPY Claimed 38.72 KGS
1 2 ORC DOO 559
1 2 ORC EPT NCPTI
1 2 ORC STO 32
1 3 CHR SQC 188.74 KGS
TE

1 3 DTY GCESS 0 INR

1 3 DTY RDT RODTEPY Claimed 188.74 KGS
1 3 ORC DOO 559
1 3 ORC EPT NCPTI
1 3 ORC STO 32
1 4 CHR SQC 42.14 KGS
1 4 DTY GCESS 0 INR
LE

1 4 DTY RDT RODTEPY Claimed 42.14 KGS

1 4 ORC DOO 559
1 4 ORC EPT NCPTI
1 4 ORC STO 32
1 5 CHR SQC 78.55 KGS
1 5 DTY GCESS 0 INR
1 5 DTY RDT RODTEPY Claimed 78.55 KGS
1 5 ORC DOO 559
1 5 ORC EPT NCPTI
1 5 ORC STO 32
1 6 CHR SQC 45.46 KGS
1 6 DTY GCESS 0 INR
1 6 DTY RDT RODTEPY Claimed 45.46 KGS
1 6 ORC DOO 559
1 6 ORC EPT NCPTI
1 6 ORC STO 32
E. SINGLE WINDOW DECLARATION - CONSTITUENTS
[Link] 3.C SNO [Link] [Link] [Link] [Link] PCT [Link]

Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla

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Page 5 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - IV - EXPORT SCHEME DETAILS

F. SINGLE WINDOW DECLARATION - CONTROL

[Link] [Link] TYPE [Link] [Link] DT [Link] DT [Link] CD [Link] TEXT

[Link] DOCUMENTS
[Link] 3 DOCTYPCD 4. ICEGATE ID 5. IRN [Link] CD [Link] PLA [Link] DT [Link] DT

Y
1 0 271000 NEOLOGCOK1 2021042900091552 KOLLAM 29-APR-21
1 0 101000 NEOLOGCOK1 2021042900091555 NEW DELHI 10-JUL-20
1 0 331000 NEOLOGCOK1 2021042900091551 KOLLAM 29-APR-21

OP
1 0 934000 NEOLOGCOK1 2021042900091553 KOLLAM 29-APR-21
1 0 325000 NEOLOGCOK1 2021042900091554 DUBAI 29-APR-21
[Link] DETAILS
[Link] [Link] NO [Link] AMOUNT [Link]
1 EX-01 TC 1226.4 USD
[Link] DETAILS
[Link] [Link] [Link] [Link]

J.AR4 DETAILS
[Link] [Link] 3.AR4 NUMBER 4.AR4 DATE [Link] [Link] [Link]
OTHER ADDITIONAL INFORMATION

OR

K. THIRD PARTY DETAILS

[Link] [Link] [Link] 4. EXPORTER NAME 5. ADDRESS [Link] ID AND TYPE

L. ITEM MANUFACTURER/PRODUCER/GROWER DETAILS

XP

[Link] [Link] [Link] CD [Link] STATE [Link] CY [Link]

M. RODTEP DETAILS
[Link] 3. QUANTITY 4. UQC 5. NO. OF UNITS 6. VALUE
TE

1 1 259.8 KGS 1 185

1 2 38.72 KGS 1 28
1 3 188.74 KGS 1 141
1 4 42.14 KGS 1 37
1 5 78.55 KGS 1 34
1 6 45.46 KGS 1 25
LE

Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla

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Page 6 Of 7
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INCOK1 1476773 30-APR-21
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br BPSPN8033E 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 32BPSPN8033E1ZS GSN
GOVERNMENT OF INDIA CB CODE AAHFN1642GCH001
TYPE INV ITEM CONT
Nos 1 6 0
COCHIN CUSTOM HOUSE WILLINGDON ISLAND COCHIN682009 PKG 126 [Link] KGS 777.01 * SB22300420211535

PART - V - DECLARATIONS

Y
OP
TC
A. DECLARATION STATEMENT

OR
XP
TE
LE
B. AUTHORIZED
SIGNATORY

DATE AUTHORIZED SIGNATORY CHA NAME :AAHFN1642GCH001

PLACE

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Page 7 Of 7