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Application for Import Original/Duplicate/Triplicate/Quadruplicate/Quintuplicate

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.......................... Please allow..........................................................................importer, to import (full name and address of importer) the undermentioned goods to be brought over by Rail/River/Cart/Head Load/or other mode of conveyance to....................... (place) from.......................(place) (Foreign territory) No. and Description of packages Identi....

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.... Customs Officer No. of packages.........(in words).................. Net weight......................(in words)......... Total value..............................(in words) Tariff value (if any) (in words)............. Total real value (in words).................... Total duty (in words).............................. N.B. - In cases in which more than one unit of quantity is indicated in t....

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....t or Ledger No............ Number and date of entry.......... No. & date of Money Order........ Name of person tendering payment............................................. Amount paid Rs............ (in words) Under Head I-Land Customs : Amount Rupees....... (in words)......... Amount Rupees (in words).......... Import Date of Payment............................. (Signature of Tenderer).....

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....................................................................... 4. Tare......................................................................................... 5. Net weight.............................................................................. 6. Total net weight of the consignment................................. 7. Description of goods............................................