EAST AFRICAN COMMUNITY SINGLE ADMINISTRATIVE DOCUMENT(SAD)-ICMS A CUSTOMS OFFICE C.

17C
1DECLARATION
23NBOEX112828484
1 2 Consignor/Exporter PIN/TIN EX1
KE NBO NEX
KE P051806050I 3 Page Of 4 Total gr. mass
15/11/2023
Ramoda Ceramics Limited 1 1 29,400.0000
5 Total Items 6 Total packages 7 Reference number
18833 - 00500 DAR ES SALAAM ROAD NA KE 1 1,000

8 Consignee PIN/TIN 9a Total freight 9b Total insurance

SS 0.0000 0.0000
NARURA GENERAL TRADING CO.LTD 9c Total Other Charges 9d Total Customs Value
774,074.9800
P O BOX JUBA SOUTH SUDAN 12 Valuation method
CUSTOMS OFFICE

1
14 Declarant/Representative PIN/TIN 15a Country of Last Consignment 16 Date of exit/arrival
KE P051363664G KE 11/15/23 12:00 AM
FELICLEARCON COMPANY LIMITED
17a Country of Destination 17b Region of destination code (Kenya
58573 - 00200 AIRPORT NOTH RD NAIROBI CITY (SOUTH) KE SS county)
Declarant ref.number CAL/000133/20
18 Identity and nationality of means of transport at departure/on 19 Ctr. 20 Delivery terms
arrival
SSD967S/ZD2213 0 EXW ISINYA
21 Identity and nationality of active means of transport crossing the border 22 Currency and total amount invoiced 23 Exchange rate
USD 5100 151.779408664
25 Mode of transport 26 Inland mode 27 Place of 28 Financial and banking data
loading/unloading
3 Road at the border 3 Road of transport
29 Office of exit / entry 30 Location of goods
1 MAL MLB
Marks and numbers - Container No(s) - Number and kind 32 Item 33 Commodity HS Code
001 No 69072300
Type Reference Quantity Marks Gross weight Description of 34 Country origin Code 35 Gross mass (kg) 36 Preference
RAMODA INVO CERAMIC a KE 29400
BX 1 1000 29400
31 NO. 13005458 FLOOR TILES
37 P R O C E D U R E 38 Net mass (kg) 39 Quota
Packages
1000 101 29400
and
structured 40 Previous document 41a Supplementary units
description
of goods 1900 MTK
41b Supplementary units 42 Item price
Manifest registration Prefix of the TD 5100
Bill code Commercial description of the goods
number
CERAMIC FLOOR TILES;
Tariff
description of -- Of a water absorption coefficient by weight exceeding 10 %
the goods
44 NAME AVALUE NAME AVALUE
Additional 45a FOB value 45b Freight value 45c Insurance cost
information CommonName CERAMIC FLOOR
Document
s 774074.98 0 0
produced/
Certificat 45d Other Charges 46 Customs value
0 774074.98

Tax Type Tax Base Rate Amount MP 48 Deferred payment 49 Identification of warehouse
Total Tax due for this item:
47 B ACCOUNTING DETAILS Tax Type TAX_AMOUNT MP
Calculation
of taxes Totals all item 0.00 Total Tax due :
B.No
Amount
50 Principal No C OFFICE OF DEPARTURE

51
Intended
Represented
offices of
transit Place and
52 Remarks 53 Office of destination (and country)

D/J CONTROL BY OFFICE OF DEPARTURE/DESTINATION Stamp:15/11/2023 7.37 PM 54 Place and date:

Result:
Seals affixed: Signature and name of declarant/representative:
Identity:
Time limit (date):
Signature:

I/We CSAP051363664GA the undersigned of FELICLEARCON COMPANY LIMITED being the agent/principal of Ramoda Ceramics Limited do hereby declare that the information and
particulars declared herein are true and complete.
Signature and stamp

Place: 58573 - 00200 AIRPORT NOTH RD NAIROBI CITY (SOUTH) KE

Tel/Fax:

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