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Application for Import Original/Duplicate/Triplicate/Quadruplicate/Quintuplicate

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..... ............(place) (Foreign territory) No. and Description of packages Identifying Marks and Nos. Description of the goods. Govt. Stores/Private Merchandise Item No. and trade description of goods according to the Indian Trade Classification issued by the Department of Commercial Intelligence and Statistics, <!--?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /--> Calcutta Weght, quantity or unit. Quantity of goods in the unit or units according to the Indian Trade Classification issued by the Department of Com .....

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..... ...(in words)......... Total value..............................(in words) Tariff value (if any) (in words)............. Total real value (in words).................... Total duty (in words).............................. N.B. - In cases in which more than one unit of quantity is indicated in the fourth column under the column heading Particulars required in addition to value ) of the Indian trade classification, the quantity shall be indicated in Col. No. 7 above in terms of all such units. DECLARATION BY THE IMPORTER ASS .....

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..... ture of Tenderer)........ ( Signature of owner or his authorised agent) Date........... (Signature of Land Customs Officer at Land Customs Stations) Date.................... CERTIFICATE OF PAYMENT Received payment of Rs................ (in words)......................................... Deposit No...................(Signature) Date................................(Treasury) Signature of owner or his authorised agent.......................... Date........... (N.B.-M.O. rec- eipt to be shown to the Land Cus- toms Officer) .....

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