Detailed Declaration - New [2023] - S.A.D.

, hardcopy

AOFFICE OF DESTINATION
1 DECLARATION FORM BRJ03
2 Exporter No. IM 4 Birgunj Customs Office, ICP
CVSUMATERA Customs Reference
3 Forms 4 CTDno
1 1 Manifest

5 Items 6 Tot pack. 7 Reference number

1 2023

8 Importer No. 9 Invoice/Transport document No.

SHAHTRADECONCERNPVT.LTD. 55
Kathmandu, Kathmandu MC, Khadya Kir
Ashish Shah
Country last 11 Trading 12 Value details 13 WHSDays
ID con. ID cty. 0.00

14 Declarant/Agent/Represen... No. 649 15 Country of export 15 C.E. Code 17 C.D. Code

Naul Bahadur Tamang Indonesia ID
Sunkoshi-6, Okhaldhunga 16 Country of origin 17 Country of destination
PAN : 121365422 Indonesia
18 Flight or Vehicle number 19 Ctr. 20 Delivery terms & Place
1111111 C&F GG
21 More Vehicle Number 55 Consolidation 22 Currency & total amount invoiced 23 Exch. rate 24 Nature of
1111111 Declarations USD 24,480.00 130.8300 transac.

25 Mode transport 26 Inland mode 27 Place of destination 28 Banking Information Bank Code
02 at border 02 Transport Terms of payment
29 Office of entry 30 Location of goods

31 Packages Numbers & Packages 32 Item 33 Commodity code (Harmonized C...

and. Number of 1 No. 10059000 000
description packages 34 Cty. orig. Code 35 Gross mass (kg) 36 Prefer.
of goods and kind ID 81,000.0000
37PROCEDURE 38 Net mass (kg) 39 Quota
Containers No(s) 4000 000 81,000.0000
40 Summary declaration / Previous document S/L
Maize (excl seed)

41 Supplementary units 42 Item Price 43 V.M.

44 Add. info KGM 81,000.0000 24,480.00 code.
Licence No D.Val D.Qty
Documents 0.00+0.00+0.00+0.00-0.00 Dispute Code A.I. Code 45 Adjustment
Produced
A.D. 100 103 907 1.0000
Certificates
and autho- 41bis Write-off units 46 Statistical value
rization 3,202,718.40
47 Calcul- Type Tax base Rate Amount MP 48 Deferred payment 49 Identification of warehouse
ation of
ID 3,202,719.00 10.00 320,272.00 1
taxes
VAT 3,522,991.00 13.00 0.00 1 B ACCOUNTING DETAILS

Mode of payment CASH

Assessment number Date
Receipt number Date
Guarantee 0.00 Date
Total fees 565.00 NPR

Total 320,272.00 1 Total declaration 320,837.00 NPR

50 Principal No. Signature COFFICEOFDEPARTURE

51 Intended Represented by
offices Place and date
of transit
and
country
52 Guarantee Code 53 Office of destination and country
not valid for
D CONTROL BY OFFICE OF DESTINATION 54 Place and date
Naula Bahadur Tamang

Inspector's Name and Signature Stamp: Customs Officer Name and Signature

NECAS - ASYCUDAWorld - Date 1/12/23 3:11 PM Page - 1 -