FORM - H - COURIER SHIPPING BILL– IV (CSB - IV) FOR GOODS - Courier Imports and Exports (Electronic Declaration and Processing) Regulations, 2010

FORM - H [See regulation 6(3)] COURIER SHIPPING BILL IV (CSB - IV) FOR GOODS (Electronic Filing) S. No. Description Details 1. Courier Registration Number 2. Name and address of the Authorized Courier 3. Name of the airlines 4. Airport of departure 5. Flight No. 6. Date of departure 7. Time of departure 8. Airport of destination 9. Airway Bill-wise information: (a) MAWB No. (b) No. of HAWBs included in this MAWB (c) Number of bags / packages / pieces / ULD 10. Shipment / consignment-wise information: HAWB No. Value Description of the Goods (1) (2) (3) Name and address of the consignor Name and address of the consignee Weight (In KGs) (4) (5) (6) DECLARATION I / We hereby declare that I/we have obtained the authorization from each of the consignors mentioned above to act as an agent for the clearance of the goods described above. I / We hereby declare that the goods for export as per this Shipping Bill include only bonafide commercial samples, prototypes of goods 1 [ , empty durable container including accessories thereof, imported in relation to COVID -19 vaccines ] and bonafide gifts of articles for personal use within the value limits prescribed in the relevant exemption Notification and which are for the time being not subject to any prohibition or restriction on their export from India and no transfer of foreign exchange is involved. I / We enclose herewith __________ (number) of airway bills and ________ (number) of invoices for the aforesaid consignments with this shipping bills. I / We hereby declare that the contents of this shipping bill are true and correct in every respect and are in accordance with the Airway Bills, the invoices and other documents attached herewith. Date: Signature and name of the authorised courier Place: ************* NOTES:- 1. Inserted vide NOTIFICATION NO. 115/2020-Customs (N.T.) dated 30-12-2020