Form Courier Bill of Entry-IV (CBE-IV)
[See regulation 5]

Courier Bill of Entry for Samples and Free Gifts

Name & Address of the Authorised Courier

Airport of Arrival

Flight No.

Date of Arrival

Airport of Shipment

Customs Serial No. and date

Sl. No.

AWB No.

No. of packages

Consignees Name & Address

State of Consumption of imported goods

Description of goods

Qty.

Invoice Value

Rate of Exchange

Assessable Value (Sec. 14)

CTH/Notfn. No.

Value under section 3 of Customs tariff Act, 1975

Additional

Duty Rate

Additional Duty Amount

GST Code

IGST Rate

IGST Exemption Notification

 

IGST Amount

GST Compensation Cess rate

GST Compensation Cess Exemption Notification

GST Compensation Cess amount

Total Duty

Declaration

(i) I/We hereby declare that I/we have obtained the authorisation from each of the consignees mentioned above to act as an agent for the clearance of the goods described above.

(ii) I/We hereby declare that the goods imported as per this Bill of Entry include only bona fide commercial samples, prototypes of goods and bona fide gifts of articles for personal use of a value not exceeding the value prescribed under the Courier Imports and Exports (Clearance) Regulations, 1998 and which are for the time being not subject to any prohibition or restriction on their import into India.

(iii) I/We enclose herewith ........... (number) of airway bills and .......... (number) of invoices for the aforesaid consignments with this Bill of Entry.

(iv) I/We hereby declare that the contents of this Bill of Entry are true and correct in every respect and are in accordance with the Airway Bills, the invoices and other documents attached herewith.

Signature and Stamp
of Authorised Courier.

Signature of Assessing Officer                       Signature of Audit Officer

                                                                    (Passed out of customs charge)
                                                                    Signature of the Proper Officer.