Customs Declaration Form of Imported GoodsPre-in put No.:Customs Serial No.:Import Port:Fili ng No.:Date of Importati on:Date of Declarati on:Operati ng Age ncy:Mode of Tran sport:Means of Tran sport:B/L No.Con sig nee:Mode of Trade:Levy or Exempti on:Tax RateLice nse No.Country (Regi on) of Departure:Port of Load ing:Domestic Desti nati on:Approval No.Mode of Tran sact ionFreightPremiumsSundry ChargesCon tract No.Number of PackagesKind of Pack ingGross Weight (kg)Net Weight (kg)Container No.Docume nts AttachedUseMarks & Nos. and RemarksItem No. Commodity CodeName&SpecificationQuanti y&UnitPlace of Origin Unit Price Total Price Currency ExemptionLevy of Taxes and FeesKeyboarder:Recorde Age ncy:This is to hereby declare that the above declarationCustoms Exam in ati onComme ntand theApproval Date (stamp should be affixed here)Form In spector:Price In spector:items are correct. If any item found false, the application entity will bear the legal liability.Declara nt:Un it Address:Applicati on En tity (stamp):Zip Code:Tel:Date of Fili ng:Tax Collector:Statisticia n:In spector:Approver: