6/22/2018 Aplikasi Yacht

REPUBLIC OF INDONESIA
MINISTRY OF FINANCE
DIRECTORATE GENERAL OF CUSTOMS AND EXCISE
(VESSEL DECLARATION)

Request ID No: BTIVD-20180111-144713, Date : 12-Jan-2018

Importer's Name (If not the Owner/Captain, Please A ach procura on) FILLED BY CUSTOMS OFFICIAL
Captain IMPORT
ID Type, ID Number, & Importer's Address Registry Number Date of Registry
Passport NM0C9FFL1 9 bay view rd, Whangarei, New Zealand BCBTI-20180112-093725 12-Jan-2018
Captain's Name Ship Cer ficate/Par cular : Ada (Present)
Procura on, in case Importer is not The Captain / Owner of the Vessel:
Frits Groeneveld
Tidak Ada (Not Present)
Captain's email & Phone Number Customs Office Rate
fritsgnz@gmail.com 00881623448101 KPPBC Tipe Madya Pabean C Bitung 1 USD = Rp 13.445,0000
Purpose of Visi ng Indonesia Email address of Customs Office
SPORT bcbitung@customs.go.id
Last Port before Indonesia Date of approval :
Timor-Leste 12-Jan-2018
Next Des na on Port (point to point) Approval of Customs Official
Papua Barat, jayapura, Teluk Tana Mera, TelukDemta
Re-Export Des na on Port Name : Zulkarnain
Bandar Bintan Telani, Bintan, Riau Islands Province NIP : 19791125 200012 1
FOREIGN YACHT INFORMATION DETAIL
Registry Number & Port of Registry Vessel Name, Call Sign, & Na onality/Flag
P2015235890 Nederlands Rampetamper ZMU6504 Netherlands
>Name of Vessel Owner Issuer of Ship Cer ficate/Par cular
Frits Groeneveld ANWB
Produc on Year Lenght Width Gross/Ne Tonnage Vessel Propulsion & Vessel Type
1974 10.6Mtr 6.5Mtr 7Ton Inboard diesel engin Yacht
WRITTEN GUARANTEE AND IMPORTER’S STATEMENT
01. I am responsible for the foreign yacht and/or any objects on board in case of a viola on of indonesian customs regula on.
02. I am willing to ac vate AIS (Automa c Iden fica on System) of foreign yachts as long as it is in Indonesian territory to support surveillance by
customs officers.
03. I will convey Vessel Declara on to customs officers both when entering Indonesian customs territory for temporary importa on process and exi ng
Indonesian customs territory for re-exporta on process.
04. I accept the determina on of customs value and tariff undertaken by Indonesia customs officer in order to meet Indonesia customs regula on.
05. I am responsible for the foreign yacht and any objects on board while in Indonesian customs territory, that:
a. it won't be sold, rented, gi ed, disposed in Indonesia without the permission of customs officers, and
b. it won't be used for commercial purposes within Indonesia territory.*
06. I guarantee to fulfill import du es and other import tax payable. If there is a customs obliga on that I cannot be met, I am capable of paying all
customs duty, import tax, and/or administra on sanc ons 100% of the customs duty which is supposed to be paid to the customs office in a
maximum of 6 working days since the le er of disbursement guarantee is received.
07. The wri en guarantees and this statement is valid for foreign vessel and goods thereon are in Indonesia customs territory star ng from 12-Jan-
2018.
08. If I do not obey the regula on above, I have no objec on to the act of customs officer to desist and to seize the foreign yatch that I mastered
including the goods thereon to fulfill the se lement according to the regula on.
* Only applies to Foreign Yacht
I hereby declare that the foregoing is a true and faithful report in every aspect and I have understood the content of Importer/Vessel Captain's
Statement
Ambon, 12-Jan-2018
Importer / Captain

Captain
FILLED BY CUSTOMS OFFICIAL
RE-EXPORT
Registry Number Date of Registry Approval of Customs Official
EXAMB-20180621-151703 21-Jun-2018

This ship departs to : Dili, Timor Leste

From : Ambon
On the date : 21-Jun-2018 Name : Santje Asbay
NIP__: 196407101983032003

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