Republic of the Philippines

Department Of Finance
BUREAU OF CUSTOMS

Statement OF Settlement Of Duties And Taxes

Customs Office P02B Port of Manila Int`l Container Port

Identification of the declaration

Registration Assessment

Declaration Ref Year Number Date Number Date

4 4 2019 C-209396 2019-07-26 L-311053 2019-07-29

Reference Number : J79B1900036

Declarant : JOHN PAULO SIMBALA BONSOL

447424322000 46 TIERRA ALTA TAAL

Importer : ADEL PACKAGING CREATIONS INC.

007193977000 NO. 11 DON JOSE EXT. COR. SAMONTE R
D., BRGY. HOLY SPIRIT DILIMAN
QUEZON CITY 1127
PHILIPPINES

Receipt Number : R - 309487 Receipt Date : 2019-07-30

Mode Of Payment: CASH PAYMENT

Message No : 9289924 AAB Ref No : 010533457-0008909

Item Taxes

CUD 3774.00
VAT 16804.00

Total Item Taxes: 20578.00

Global Taxes

IPF 250.00
Other Global 280.00
Total Global Taxes: 530.00

Total Assessed Amount: 21108.00

Collection Date : 2019-07-30T09:40:29

Mode Of Payment: NON CASH PAYMENT

IED Number : Remaining Amount :

Tax Debit Memo

TDM Number TDM Amount

Tax Credit Certificate

TCC Number : TCC Balance :

Bond Account Number:

Bonds Amount : Bonds Account Balance: