To be submitted in duplicate - Regulation 4

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..... ode GSTIN or as applicable AD code (if applicable) Details of Authorised Agent Customs Broker LicenseNo. Name and address .....

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..... : Signature of officer of Customs along with stamp and date. Details of parcel Consignee details Product details Details of Parcel Postal tracking number Assessable value under section 14 of the Customs Act Name and Address Country of des .....

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..... H.S code Invoice details value Customs duties GST details Total invoice no. and date Sl. No. of item in invoice Export duty Cess IGST (if applicable) Compensation cess (if applicable) LUT/ bo .....

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