EXPORT DECLARATION DOCUMENT

1 DECLARATION Office Code:P02B

2 Exporter /Supplier, Address: Manila Int`l Container Port
EX1 1
BEVI ASIA PACIFIC INC. Manifest No:
3/F 1262 BATANGAS ST., SAN ISIDRO MAKATI CITY 1234 3 Page Entry Number: E-1032050
PHILIPPINES
1 1 of 2 Date : 09/30/2020
5 Items 6 Tot Pack 7 Reference No:

1 3,393 LYYB000011E

C 8 Importer/Consignee, Address: 9 CRF

PT. UICCP INDONESIA NA
U WISMA UIC LT. 4, JL JEND. GATOT SUBROTO KAV. 6 7,
KARET SEMANGGI SETIABUDI JAKARTA SELATAN 10 11 12 Tot. F/I/O 13 T. Rel.
S INDONESIA

T 14 Broker/Attorney-In-Fact: TIN : 15 Country of Export 15 C.E. Code

427050144000
O DARYL F. SANTOS PHILIPPINES
16 Country of Origin 17 Country of Destination
M
PHILIPPINES INDONESIA
S
18 Vessel/Aircraft: 19 Ct 20 Terms Of Delivery

SEASPAN NEWYORK V006S 1 FOB - Free On Board

21 Local Carrier (If Any) : 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank

USD 190,372.80 48.545 0

25 26 Province of Origin 27 Port of Loading 28 Financial and Banking Data Bank Code : 998
XX
137602000-City of Makati
PHMNL Terms of Payment : 01 - Basic
29 Port Of Departure 30 Location Of Goods
1 S03 - INTERNATIONAL
Bank Name : PCHC
P02B - Manila Int`l Container Port
CONTAINER TERMINAL IN Branch : NA Bank Ref No. : 010533457-0010596
Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Tariff Spec
Marks & Nos : NM
No. Of Packages : 3,393 1 34011190000
Number and Kind : CT - CARTON
31 Packages Containers No(s) : 34 C.O. Code 35 Item Gross Wgt. 36 Pref
and Desc.
Of Goods FSCU5097660
- - - Other PH 23,952.85 Kg(s)
KOJIE SAN SOAP
37 Procedure Item Net Weight 39 Quota

1000 000 21,534.96 Kg(s) NNNNN

40a AWB/BL 40b Previous Doc No.

44 Add Infos OTHInEV : 0 INSinFRT : 0 Fine : 0 41 Suppl. Units 42 Item Customs Value (F.C.) 43 V.M.
Doc / Produ.
Certif. & Aut. 48.54 + 48.54 + 48.54 + 0.00 - 0.00 3,393.00 190,372.80 1

45 Adjustment

0.00

46 Dutiable Value (PHP)

Invoice No. : NA Dump Bond :

48 Prepaid Account No. 49 Identification of Warehouse

47 Calcula- Type Tax Base Rate Amount MP
tion of Taxes

47b ACCOUNTING DETAILS

.............................................................................................................................
:
Mode Of Payment
Assessment Number : Date :
Receipt Number : Date :
Guarantee : Date :
.............................................................................................................................
Total Fees
Total
Total Assessment

50 We hereby certify that the information contained in all pages of this Declaration and the documents submitted are Subscribed and sworn to before me
to the best of out knowledge and belief true and correct.

DARYL F. SANTOS Administering Officer /

BEVI ASIA PACIFIC INC. Notary Public
Broker Date : Exporter/Attorney-In-Fact

51 AUTHORIZATION 52 Control at Office Destination

Date Print name Position Date Print name Position

 53 INTERNAL REVENUE (TAX PER BOX #46 & 47

TAXABLE VALUE PHP WHARFAGE OTHERS

BANK CHARGES
ARRASTRE CHARGES TOTAL LANDED COST PHP
CUSTOMS DUTY

BROKERAGE FEE DOCUMENTARY STAMP TOTAL VAT PHP

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION 55 NO. OF PACKAGES EXAMINED EXAMINATION RETURN 56 DATE RECEIVED 57 DATE RELEASED

ITEM
NO DESCRIPTION IN TARIFF TERMS SHOULD BE QTY UNIT UNIT VALUE TARIFF HEADING RATE

PLEASE REFER TO RIDER/S FOR FINDINGS ON ITHER ITEMS

REVISED CHARGES LIQUIDATION

59 CHARGES 60 DECLARATION 61 FINDINGS 62 DIFFERENCES 65 LIQUIDATION AMOUNT

PHP
DUTY

BIR Taxes
66 SHORT/EXCESS
VAT PHP
Excise Tax/Ad
Valorem 67 REMARKS

Others

Surcharges

TOTAL

63 ACTION DIRECTED / 64 68
RECOMMENDED
Date Date

69
Date Date

CONTINUATION FROM BOX # 31 FREE DISPOSAL