BOC SINGLE ADMINISTRATIVE DOCUMENT

1 DECLARATION Office Code P07

2 Exporter / Supplier Address Port of Cebu
4 4
1 PILGRIMS PRIDE CORP
1770 PROMONTORY CIRCLE GREELEY 3 Page 4
Customs Reference
C 5188 02-04-2024
CO 80634 US 1 1 Registry Number MSK0006-24
C 5 Items
1
6 Tot Pack
1800
7 Reference Number
963L40202001
8 Importer / Consignee, Address TIN: 236673060000 9 CRF NUMBER :
U GOLDEN RK FROZEN PRODUCTS TRADING
VICTORIA BUILDING UPPER LAWAAN LAWA
AN 1
TALISAY 6045
S PHILIPPINES 10 11 12 Tot. F/I/O (Php)
0.00
13 T. Ref.

14 Broker / Attorney-In-Fact, Address TIN: 360266596000 15 Country of Export 15 C.E. Code 17

T JEEFCENT LUMANTA CANQUE
505 5F 960 P PAREDES ST BRGY 462 ZO
UNITED STATES US PH

NE 046 1008 SAMPALOC NCR MANILA 16 Country of Origin 17 Country of Destination

MANILA 1008
O PHILIPPINES UNITED STATES PHILIPPINES
18 Vessel / Aircraft 19 Ct 20 Terms of Delivery
MCC YANGON CIF
M 21 Local Carrier (if any) 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank
USD 27,749.28 56.185 2 X
S 25
2/6/2024
26 27 Transhipment Port
28 Financial and Banking Data - Bank Code 998
Terms of Payment 01 - Basic
29 Port of Destination 30 Location of Goods
1 P07
Port of Cebu S06
Bank Name

Branch
PCHC
N.A. Bank Ref Number: 010620140-2362827

31 Packages Marks and Numbers - Container No(s) 32 Item No. 33 HS Code Spec Code
and 1 02071499 200 000000
Marks & No 1X40
Description of Packages 34 C.O. Code 35 Item Gross Weight (kg) 36 Pref
of Goods
Number and Kind1800 NE UNDETERMINED/UNPACKED/UNPAKAGED US 28,029.58 None

Container No(s)MNBU4184379 37 Procedure 38 Item Net Weight (kg) 39 Qouta

- - - - Out-Quota
4000 0N1 25,226.62 NNNNN
Others
FROZEN CHICKEN LEG QUARTERS 40a AWB / BL 40b Previous Doc No.
MAEU233565867
41 Suppl. Units 42 Item Customs Value (F. Cur) 43 V.M.

27,749.28 NV
44 Add Infos OTHinEV : 1 INSinFRT : 1 Fine :
Doc / Product A.I. Code 45 Adjustment
Certif. & 0.00 + 0.00 + 0.00 + 953.00 - 3,083.25
Aut 1.00
A.D.

MSP 46 Dutiable Value (PHP)

0.00 1,559,093.30
Invoice No. : 202313318 Dump Bond :

47 Calculation Type Tax Base Rate Amount MP 48 Prepaid Account No. 49 Identification of Warehouse
of Taxes
/
CUD 1,559,093.30 40 % 623,637.32 0
47b ACCOUNTING DETAILS
VAT 2,367,296.93 12 % 0.00 0
Method of Payment : CASH
Assessment Number : L 7211 Date : 02-05-2024
Reciept Number : R 7482 Date : 02-06-2024
Guarantee 0.00 Date :
SGD 172,251.18 Total Fees 174,092.18
Total Item: 795,888.50 Total Assessment 797,729.50

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

51 AUTHO- Broker : Date : Importer / Attorney-in-Fact :

RIZATION Administering Officer
JEEFCENT LUMANTA CANQUE GOLDEN RK FROZEN PRODUCTS TRADING Notary Public

52 Control Code 53 Office of Destination and Country

at Office Destination
CONTROL AT OFFICE OF DESTINATION Stamp 54 Place and date

Signature