• APPENDIX - A
• ANNEXURE-A
• GUIDELINES

APPENDIX - A

FORMAT FOR DECLARATION AT SERVICE CENTRE FOR DATA ENTRY

1.	(a)	CHA Licence No.	:
	(b)	Name	:
	(c)	Address of the CHA	:
2.	Importer Particulars
	(a)	Importer-Exporter Code(IEC)	:	(b)	Branch Serial Number
	(c)	Name of the Importer	:
	(d)	Address
3.	Type of Importer(Tick)		:	(a)	Government Departments (G)
				(b)	Government Undertakings (U)
				(c)	Diplomatic/UN and its Organisations(O)
				(d)	Others (P)
4.	Authorized Dealer Code of the bank		:
5.	Type of Bill of Entry
	(A)	(H) Home Consumption
		(W) Warehouse
		(X) Ex-bond
	(B)	(N) Normal Bill of Entry (after filing of IGM and after entry inward)
		(P) Prior BE (after filing of IGM and before entry inward)
		(A) Advance Bill of Entry (filed before filing of IGM and before entry inward)
	(C)	High Sea Sale (HSS)	:	Yes/No
		If yes, high sea seller particulars-
		(a) Importer-Exporter Code(IEC)	:
		(b) Branch Serial Number	:
		(c) Name of the high sea seller	:
		(d) Address	:
	(D)	Section 46 (1) Proviso Case	:	Yes/No
6.		Special requests, if any
		(A) First Check requested	:	Yes/No
		(B) Green Channel facility for clearance without examination requested	:	Yes/No
		(C) Urgent clearance requested against temporary documentation (kachcha B/E)	:	Yes/No
		(D) Extension of time limit requested under Section 48	:	Yes/No
	If yes, reasons for late filing of BE :-
7.	Port of Shipment		:
8.	Country of Origin (if same for all goods of the consignment, otherwise declare at the item level at S.No. 39 )		:
9.	Country of Consignment		:
IGM Details
10.	(a) Import General Manifest (IGM) No./Year		:
	(b) Date of entry inward		:
11.	(a) Master Airway Bill(MAWB) No./ Bill of Lading (HBL) No.		:
	(b) Date		:
12.	(a) House Airway Bill No(HAWB)./ House Bill of Lading(HBL) No.		:
	(b) Date		:
13.	Marks & Numbers		:
14.	(a) Number of Packages		:
	(b) Type of Package		:
15.	(a) Gross Weight		:
	(b) Unit of weight		:
16.	Additional information for clearance of goods at Inland Cantainer Depots(ICDs)
	(a) Name of the gateway port		:
	(b) Gateway IGM Number		:
	(c) Date of entry inwards at gateway port		:
17.	Container details, (in case of clearance at ICDs and Sea Ports) wherever applicable

---

CONTAINER NO

SEAL NO

FCL/LCL

---

BOND DETAILS
18.	(a) Whether clearance of imported goods is sought against any type of Bond already registered with customs: Yes/No
	(b) IF YES, particulars of bond		:	-------------------------------------------------
				Type of Bond ---------------------- ------------------------ ehousing (WH) 100% EOUs etc. (EO) Provisional Duty (PD) Job-work (JB) --------------------- ----------------------------
	(c) Details of procurement certificate, if any, from Central Excise Commissionerate.
	(i) Certificate Number	:
	(ii) Date	:
	(iii)Location code of the Central Excise Office issuing the Certificate
			Commissionerate	:
			Division	:
			Range	:
INVOICE PARTICULARS
19.	Whether Import under multiple invoices	:	Yes/No
	If Yes, (a) no of invoices	:
	(b) Total Freight	:
	(c) Total Insurance	:
DETAILS OF EACH INVOICE
20.	(a) Invoice number	:	(b) Date:
21.	(a) Purchase Order Number	:	(b) Date:
22.	(a) Contract Number	:	(b) Date:
23.	(a) Letter of Credit (LC) Number	:	(b) Date:
24.	Supplier details
	(a) Name of the supplier	:
	(b) Address	:
	(c) Country	:
25.	If supplier is not the seller, -
	(a) name of the seller	:
	(b) Address	:
	(c) country	:
26.	Broker/Agent details	:
	(a) name of the broker/agent	:
	(b) address	:
	(c) country	:
27.	Nature of transaction (Tick)
	(a) Sale
	(b) Sale on consignment basis
	(c) Hire/Rent
	(d) Replacement
	(e) Gift
	(f) Sample
	(g) Free of cost.
	(h) Other
28.	Terms of Payment (Tick)
	(a) LC
	(b) DP / DA
	(c) FOC
	(d) Others
29.	Conditions or restrictions, if any, attached to the sale
30.	Method of valuation applicable	:
31.	(a) Invoice value	:	(b) Currency	:
32.	Terms of invoice (Tick)	:	(a) FOB/ (b) CIF /
	(c) CI / (d) CF
33.	Freight, Insurance and other charges	: Rate (%) OR Amount Currency
	(a) Freight	:
	(b) Insurance	:
	(c) Loading, unloading and handling charges[ Rule 9(2)(b)]	:	1%
	(d) Other charges related to the carriage of goods (eg. daughter vessel expenses, transit/transshipment charges etc)	:
34.	Cost and services not included in the invoice value and other miscellaneous charges	Rate (%) OR Amount Currency
	(a) Brokerage and commissions	:
	(b) Cost of containers	:
	(c) Cost of Packing	:
	(d) Dismantling, transport and handling charges at the country of export or any other country	:
	(e) Cost of goods and services supplied by buyer	:
	(f) Documentation	:
	(g) Country of Origin Certificate	:
	(h) Royalties and licence fees	:
	(i) Value of proceeds which accrue to seller	:
	(j) Cost of warranty services if any, provided by the seller or on behalf of the seller	:
	(k) Other costs or payments, if any, to satisfy the obligation of the seller	:
	(l) Other charges and payments, if any	:
35.	Discount, if any	:	Yes/No
	If yes,
	(a) Nature of Discount	:
	(b) Rate (%) or amount	:
36.	Additional charges, if any for purchase on high seas	:	Rate (%) OR	Amount (In Rs.)
37.	Any other relevant information which has a bearing on value	:
38.	Details of SVB Loading wherever applicable (at Invoice level)	:
	(if same for all goods of the consignment, otherwise declare at the item level at S.No.39)
	Whether the buyer & seller are related	:	Yes/No
	If yes, whether relationship has been examined earlier by SVB	:	Yes/No
	If yes,
	(a) Ref No	:
	(b) Date	:
	(c) Custom House	:
	(d) Load on	:	(A) Assessable value
			(B) Duty
			(C) Both
	(e) Loading rate	Assessable Value Duty
	Rate in %age	:
	(f) Provisional (P)/ Final (F)	:
39.	Items of Import:
A. Detailed Description of Items: (1) Invoice Serial Number: (2) Actual Invoice Number

Item No	Item Description	Generic Description	Unit Price	Quantity	Unit of Quantity	Accessories, If any	Manufacturer’s Name	Brand	Model/grade/specification	End use of the item	Country of Origin	Previous imports, if any
												B/E No.	Date	Unit Value	Currency	Custom House
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17

B. Classification Details (1) Invoice Serial Number:

(2) Actual Invoice Number:

	Classification Details												Import Licencing Details			SVB Details
Item No.	RITC	CTH	Notn./Sl No	CETH	Notn/Sl No.	Spl Addl Duty Notn/ Sl no	SIA Notn/ Sl no	SED Notn/ Sl No	TTA Notn/ Sl No.	NCD Duty Notn/ Sl no	Re- Import Y/N	RSP Per Unit	Exim scheme code, if any	Import against licence Y/N	Para No/ Year of Exim Policy	SVB Ref. No/	Date	Custom House	Load on Assess value	Load on duty	Prpv (P) / Final (F)
1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22

C. In case of re-import, Shipping Bill Details. (1) Invoice Serial Number

(2) Actual Invoice Number

Item No.	Shipping Bill No.	Shipping Bill date	Port of Export	Invoice No. of SB	Item Sl. No. in SB	Payments made for export on Pro-rata basis (In Rs.) Freight Insurance
1	2	3	4	5	6	7	8

D Details relating to duty Exemption based on Exim Schemes and Licence particulars. (1) Invoice Serial Number

(2) Actual Invoice Number

Item No	Addl Duty Exmpn. Requested Y/N	Notification/ Sl.No.	Licence Regn. No.	Licence Regn. Date	Debit Value (Rs.)	Debit Qty.	Unit	Item Sl. No. in Licence
1	2	3	4	5	6	7	8	9

I enclose herewith the copies of following import documents:

(1) INVOICE

(2) PACKING LIST

NOTE: Where the Invoice contains more than one unit of item and more than one description of items, UNIT PRICE of each item shall be mandatory.

DECLARATION:

I certify that aforesaid declaration, the documents & the information contained therein is true and correct in all respects.

Signature: Name of the Signatory: Name of the Importer/ Authorized Customs House Agent :

Date: