Form for claim of drawback under rule 12

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....ACK FORM NO. To The Assistant/Deputy Commissioner of Customs (Drawback) Foreign Post Office ___________________. We, ___________________ propose to export the undermentioned consignment. Name and Address of the Consignee ___________________________________________. S. No. Date of Parcels Gross Weight Marks/No. of Pcs. Qty. FOB Value Rate of Net Dbk. Weight....

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...._ detailed above. The parcels have been packed in my presence and sealed by me with lead/wax seal No. _______ bearing the following particulars _______________. Signature of the officer who examined and sealed the consignment Date: Place: Certified that the above noted parcels were examined, packed and sealed under my supervision. Signature of Supdt. Of Customs/Central Excise Dat....