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GOODS DECLARATION. GD-I X Custom File No.

[ ] BILL OF ENTRY [ ] BILL OF EXPORT [ ] BAGGAGE DECLARATION [ ] TRANSSHIPMENT PERMIT


2.DECLARATION TYPE 3.VALUATION 4.PREVIOUS REF
1.EXPORTER'S/CONSIGNOR'S NAME AND ADDRESS

1592
EB METHOD KAPW-IB-163141-21-04-2015
LOTTE CHEMICAL TITAN TRADING 5.PAGE 1 OF 6.CUSTOM OFFICE 7.BANK CODE
1 MCC Appraisement Karachi West - Import
SDN BHD
PLO 312,JALAN TEMBAGA 4,PASIR 8.IGM/EGM NO & DT KAPW-85-2015 Date: 02-04-2015 INDEX 844

10.IMPORTER'S/CONSIGNEE'S/PASSENGER NAME & ADDRESS 9.DRY PORT IGM/EGM NO & INDEX


DT
SILVER SURGICAL COMPLEX (PVT) LTD 11.DECLARANT (OTHER THAN IMPORTER/EXPORTER)
BATLA ENTERPRISES PLOT NO.109 BLOCK-3 DRIGH COLONY
11 E BLOCK 6
12.TEL 03222978043

14.NTN 15.STR.No / PASSPORT NO & DATE 13.C.H.A.L. No 1592 Job No


16.WAREHOUSE LIC NO 17.TRANSACTION TYPE
1352367 1100901802482
02/1990 False
18.DOCUMENTS ATTACHED E-Form No Date Value
19.LC/DD NO. & DATE 20.COUNTRY OF DESTINATION
INV [ ] B/G
ULC/0117/15/04763/10/2015 12:00:00 AM Pakistan
BL/AWB/ [ ] IT EXMP
21.CURRENCY NAME & CODE 30.MARKS/ CONTAINER NOS.
CO [ ]
US $ 840
PL [ ]
22.VESSEL MODE OF 23.BL.AWL.CON.NO & DATE 24.EXCHANGE RATE
TRANSPORT OOLU2557844663 3/25/2015 12:00:00 AM 101.400000
OOCL CHICAGO, 08/04/201512:00
25.PORT OF SHIPMENT 26.PAYMENT TERMS
Tanjung Pelepas With LC
27.PORT OF DISCHARGE 28.PLACE OF DELIVERY 29.DELIVERY TERMS
CFR
31.NUMBER OF PACKAGES 32.TYPE OF PACKAGE 33.GR OSS WT 34.Volume M3

704.000 BAG 17.71200 MT

35.GENERAL DESCRIPTION OF GOODS


NET WT
17.60000MT
36.IN THE CASE OF DANGEROUS GOODS INDICATE HAZARD CLASS/DIV:FLASH Containers detail as per attached sheet
POINT
37.ITEM NO 38.QUANTITY 38(b).NO OF UNITS 39.CO CODE 40.SRO NO 41.HS Code
(a)Unit Type 5.5% Advance Income Tax u/s 148 for Industrial Undertakings--SRO136(I)/2015 dated 13.02.2015--for filer-5a
1 17600.0000 Malaysia 3902.3000
KG
42.ITEM DESCRIPTION OF GOODS 46.LEVY 47.RATE 48.SUM PAYABLE (PKR)
POLYPROPYLENE RANDOM COPOLYMER : TITANPRO SM498 CD 5.00 % 126526.0000

ST 17.00 % 451696.0000
42(a)
IT 5.50 % 170980.0000
43.UNIT VALUE 44.TOTAL VALUE 45.CUSTOM VALUE (PKR)
Declared Assessed Declared Assessed Declared Assessed

1.3900 1.3900 24464 24464 2530511.0000 2530511.0000

37.ITEM NO 38.QUANTITY 38(b).NO OF UNITS 39.CO CODE 40.SRO NO 41.HS Code


(a)Unit Type
2

42.ITEM DESCRIPTION OF GOODS 46.LEVY 47.RATE 48.SUM PAYABLE (PKR)

42(a)

43.UNIT VALUE 44.TOTAL VALUE 45.CUSTOM VALUE (PKR)


Declared Assessed Declared Assessed Declared Assessed

49.SRO / Test Report No & Dt 50.FOB VALUE 0.0000 54.LANDING CHARGES @ 1% 1.0000 %
51.FREIGHT 0.0000 55.OTHER CHARGES 0.0000

52.CFR VALUE 24464.0000 2530511.0000


56.ASSESSED VALUE PKR
53.INSURANCE 1.0000 % 57.TOTAL REBATE CLAIM/ PROV. ASSMNT U/S 81
58.MACHINE NO. 59REVENUE RECOVER 60.AMOUNT (PKR) (PKR)
64.I/we declare that the above particulars are true & corrcect.
& DATE CODE LEVY

KAPW-EB-165705- CD 126526.00
24-04-2015 ST 451696.00
61.A.O's name, sig & stamp SIG & DATE
101.400000
IT 170980.00
65..C/F/D NO & DATE
Appraiser:
XXXXXX
C-KAPW-013257-24042015
XXXXXX
Examiner:
Payment Received by NISAR AHMED ABBASI
62.P.A.s name, sig & stamp
XXXXXX
XXXXXX

63.Out of Charge Sig & Stamp


Total: 749202.0000 66.Bank Stamp

This is a system generated document, it does not require signature or stamp” as defined in sub section (kka) of Section 2 of Customs Act 1969

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