1. (a) CHA License 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 Department (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 (alter filing of IGM and alter entry Inward)

        (P) Prior BE (alter 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 I 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) Provisional 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 (HAW8) I House Bill of Lading

:

          Lading (HBL) No.

(b) Date

:

13. Marks & Numbers

:

14. (a) Number of Packages

:

      (b) Type or Package

:

15. (a) Gross Weight

:

     (b) Unit of Weight

:

16. Additional information for clearance of goods at Inland Container 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 or clearance at ICDs and Sea Ports) wherever applicable

     (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 I 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 Supplier

:

     (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 restriction, 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

:

Rent (%) 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 arid 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) Dismanting, 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

:

     (i) 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 veering 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