DECLARATION / UNDERTAKING FOR EXPORT OF

MINERALS / MINERAL PRODUCTS

TO
The joint Commissioner of customs,
Krishnapatnam Custom House,
Krishnapatnam port, SPSR Nellore Dt,
Andhra Pradesh.

Sir ,

We, M/S ……………………………………………………………

Sought That to export……………………………(M.Ts/ Cbm./ Sq.Mts) of
.…..………….(Description of goods) to………………………..(Country of
Export ) Vide . Invoice No…………………….. Dt……………Packing List
No……………….Dt…………..against Shipping Bill no………… Dt………..

We hereby declare that all the dues like Taxes / Royalty / Cesses,
as prescribed have been duly paid. We have also complied with all the rules &
regulations applicable under the various statues of state Governments /
Central Government, in respect of the Minerals/Mineral products To be
exported against the said shipping bill.

Yours Faithfully,