IMPORT REPORT

Job Number: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Name of Owner/ Operator (Transporter) Address of Owner/ Operator (Transporter) Nationality Vehicle Registration No. Railway Wagon No. Way Bill Number / Railway Receipt No. (Non Mandatory Field) : : : : : : Date:

Date of Way Bill Number / Railway Receipt No. (Non Mandatory Field) : Railway Ref.No. (Non Mandatory Field) Date & Time of Arrival Name & Address of CHA CHA License No. Identifyi ng marks and numbers 13. : : PART-A (CARGO) Container Gross Unit of No. (If Weight Weigh applicable t ) 14. IEC 19. 15. 16. Description of Goods : :

Number and description of packages 12.

17. Remarks

Name of Consignee / Importer 18.

20. NON MANDATORY OPEN ENDED FIELD

PART B ( Stores) Description of Stores (Specify here separately all non duty paid consumable / non consumable articles) NOTE- THIS MAY BE A NON MANDATORY OPEN ENDED FIELD TO BE FILLED IF THERE IS ANYTHING TO DECLARE. PART C List of private property in the possession of the person-in-charge of conveyance NOTE- THIS MAY BE A NON MANDATORY OPEN ENDED FIELD TO BE FILLED IF THERE IS ANYTHING TO DECLARE.

I/We declare that the above declaration contains a full and true account of the particulars of the import goods, stores and private property. Date: Signature & Name of Person-in-charge or Agent

TRANSHIPPING INDIAN TRUCKS REPORT Fields 1. Import Report No. and date (Not required if filed with Import Report) 2. Indian Truck No./s 3. Name of Owner/ Operator (Transporter) 4. Address of Owner/ Operator (Transporter) 5. IEC(Not required if filed with Import Report) 6. Container No./s if applicable (Not required if filed with Import Report) 7. CHA License No(Not required if filed with Import Report)

PRE-IMPORT DECLARATION FOR NEPAL Field

1. Pre-Import Declaration No. and date ________________________________________________________________________

NOTE The yellow shaded texts and fields are proposals and additions as mentioned in the LCS Import ICES Report.