COST STRUCTURE PER UNIT

BASED ON FREE ON BOARD (FOB)

(IN US$)

HS Number / : 96121010 / 1,400 PCS PARTS FOR SIDM CONSUMABLES RIBBON,#7753(B),ASIA

Description C13S015506
CONTAINER # : OBLU3314959
SEAL # : 1808934

Exported to Country : SINGAPORE

Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART JAPAN 0.25 16.53
Total A 0.25 16.53

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 0.479 31.68
Total C 0.479 31.68

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 7.28
2 OTHER DIRECT COST 0.163 10.78
Total D 0.273 18.06

E. Profit
Profit 0.51 33.73

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 1.512 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN
 COST STRUCTURE PER UNIT
BASED ON FREE ON BOARD (FOB)
(IN US$)

HS Number / : 96121010 / 3100 PCS PARTS FOR SIDM CONSUMABLES

Description RIBBON,#7753(B),ETT
C13S015523
CONTAINER # : OBLU33114959
SEAL # : 1808934
Exported to Country : SINGAPORE
Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART JAPAN 0.23 16.17
Total A 0.23 16.17

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 0.459 32.28
Total C 0.459 32.28

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 7.74
2 OTHER DIRECT COST 0.163 11.46
Total D 0.273 19.20

E. Profit
Profit 0.46 32.35

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 1.422 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN
 COST STRUCTURE PER UNIT
BASED ON FREE ON BOARD (FOB)
(IN US$)

HS Number / : 96121010 / 3200 PCS PARTS FOR SIDM CONSUMABLES

Description RIBBON,#7753(B),ETT
CONTAINER # : OBLU3314959
SEAL # : 1808934
Exported to Country : SINGAPORE
Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART JAPAN 0.23 16.17
Total A 0.23 16.17

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 0.459 32.28
Total C 0.459 32.28

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 7.74
2 OTHER DIRECT COST 0.163 11.46
Total D 0.273 19.20

E. Profit
Profit 0.46 32.35

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 1.422 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN
 COST STRUCTURE PER UNIT
BASED ON FREE ON BOARD (FOB)
(IN US$)

HS Number / : 96121010 / 100 PCS PARTS FOR SIDM CONSUMABLES

Description RIBBON,#7754(B),ETT
C13S015534
CONTAINER # : OBLU3314959
SEAL # : 1808934
Exported to Country : SINGAPORE
Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART HONG KONG 0.23 10.39
2 96121010 RIBBON PART JAPAN 0.02 0.90
Total A 0.25 11.29

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 0.8 36.15
Total C 0.8 36.15

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 4.97
2 OTHER DIRECT COST 0.163 7.37
Total D 0.273 12.34

E. Profit
Profit 0.89 40.22

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 2.213 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN
 COST STRUCTURE PER UNIT
BASED ON FREE ON BOARD (FOB)
(IN US$)

HS Number / : 96121010 / 800 PCS PARTS FOR SIDM CONSUMABLES

Description RIBBON,S015555(B),ETT
C13S015611
CONTAINER # : OBLU3314959
SEAL # : 1808934
Exported to Country : SINGAPORE
Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART JAPAN 0.68 21.68
Total A 0.68 21.68

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 0.843 26.88
Total C 0.843 26.88

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 3.51
2 OTHER DIRECT COST 0.163 5.20
Total D 0.273 8.71

E. Profit
Profit 1.34 42.73

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 3.136 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN
 COST STRUCTURE PER UNIT
BASED ON FREE ON BOARD (FOB)
(IN US$)

HS Number / : 96121010 / 2,800 PCS PARTS FOR SIDM CONSUMABLES

Description RIBBON,S015643(B),ASIA,24
C13S015643
CONTAINER # : OBLU3314959
SEAL # : 1808934
Exported to Country : SINGAPORE
Form : FORM D

A. Components Imported or Unknown Origin

No HS Number Description Origin Country Value (US$) %
1 96121010 RIBBON PART JAPAN 0.25 12.06
Total A 0.25 12.06

B. Components from ASEAN countries

No HS Number Description Origin Country Value (US$) %
N/A

C. Components from Indonesia

No HS Number Description Supplier Name Value (US$) %
1 96121010 RIBBON PARTS INDONESIA 1.75 84.42
Total C 1.75 84.42

D. Direct Production Cost

No Direct Cost Description Value (US$) %
1 LABOUR 0.11 5.31
2 OTHER DIRECT COST 0.163 7.86
Total D 0.273 13.17

E. Profit
Profit -0.2 -9.65

F. Transportation Free On Board

No Transportation Fee Description Value (US$) %
N/A

TOTAL
Total Value / FOB Value 2.073 100.00

Mar 13, 2021

Signature

HERRY
HENDRAWAN