BOC SINGLE ADMINISTRATIVE DOCUMENT

2 Exporter /Supplier Address

AB MAURI VIETNAM LTD

DONG NAI PROVINCE VIETNAM

3 Page

5 Items

6 Tot Pack

1
C
U
S
T
O
M
S

8 Importer/Consignee, Address

Office Code:
P07
Port of Cebu
Manifest No: WHL0047-15
Customs reference no.: C-31397
Date :
11/17/2015 13:28:54

1 DECLARATION

004271857000

Tin:

Registry No.

QUENN OF LUCK

10

11

XX

12 Tot. F/I/O

XX

15 C.E. Code

VIET NAM

17

VIET NAM
20 Terms Of Delivery

CFR
22 F. Cur.

Total Customs Value

USD
26

XX
30 Location Of Goods

P07-Port of Cebu

S06

31 Packages
and Desc.
Of Goods

32 Item No.

Marks & Nos :

AS ADDRESSED
No. Of Packages : 690
Number and Kind : CT-CARTON

01-Basic
Bank Ref No. :

Rate

21069091000

Item Net Weight

000

OTHInEV :

INSinFRT :

36 Pref

AFTA
39 Quota

13,800.00 Kg(s)

NNNNN

40b Previous Doc No.

40a AWB/BL

44 Add Infos
Doc / Produ.
Certif. & Aut.

0.00

14,145.00 Kg(s)

VN

DIAMOND BREAD IMPROVER

Tariff Spec

35 Item Gross Wgt.

37 Procedure

4000

010050011-3270780

33 HS Code

34 C.O. Code

Containers No(s) :
WHLU2758900
- - Other mixtures of chemicals with foodstuffs or other substances
with nutritive value

Bank Code :

Bank Name : PCHC

Branch :
NA

Marks and Numbers - Containers No(s) - Number and Kind

24 Thru Bank

46.993
998

16,428.30

Terms of Payment :

29 Port Of Destination

23 Exch Rate

28 Financial and Banking Data

27 Transhipment Port

17

VN

16 Country of Origin

21 Local Carrier (If Any) :

25

13 T. Rel.

318.37

15 Country of Export

19 Ct

WHL0047-15

1GTA1500181

690

9 CRF No.

AB MAURI PHILIPPINES INC

3RD FLOOR UNIT 32 LEGASPI SUITES BL
DG.,SALCEDO ST., LEGASPIVILLAGE
MAKATI 1129
1129
PHILIPPINES
14 Broker/Attorney-In-Fact, Address
Tin:
936227663000
GEORGE B. CORTES
HIGHWAY 77 SAINT ANTHONY STREET TAL
AMBAN, CEBU CITY
CEBU 60006000
PHILIPPINES
18 Vessel/Aircraft

7 Reference Number

0395X05338
0.000

Fine :

41 Suppl. Units

0.00

42 Item Customs Value (F.C.)

0.00

0 + 14,961 + 0 + 961 - 3,109

43 V.M.

16,428.30

45 Adjustment

1.00

Prev Doc Reference :

46 Dutiable Value (PHP)

Invoice No. :

47 Calculation of Taxes

Dump Bond :

0005039

Type

Tax Base

CUD
VAT

786,976.26
799,328.14

Rate

0%
12%

Total

Amount

786,976.26
MP

0.00
95,919.00

95,919.00

1
1

48 Prepaid Account No.

49 Identification of Warehouse

47b ACCOUNTING DETAILS

.............................................................................................................................
:
Mode Of Payment
CASH
Assessment Number
Date :
: Receipt Number
Date :
: Guarantee
Date :
:
.............................................................................................................................
Total Fees
1,499.00
Total Assessment

97,418.00

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

GEORGE B. CORTES
Broker

Administering Officer /
Notary Public

AB MAURI PHILIPPINES INC

Date :

Importer/Attorney-In-Fact

52 Control at Office Destination

51 AUTHORIZATION

Date

Subscribed and sworn to before me

Print name

Position

Date

Print name

Position

53 INTERNAL REVENUE (TAX PER BOX #46 & 47

BANK CHARGES

786,976.26
983.72

CUSTOMS DUTY

0.00

TAXABLE VALUE PHP

6,033.72

BROKERAGE FEE

961.00

WHARFAGE

3,109.00

ARRASTRE CHARGES

265.00

DOCUMENTARY STAMP

1,000.00

OTHERS

799,328.70

TOTAL LANDED COST PHP

95,919.00

TOTAL VAT PHP

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION

55 NO. OF PACKAGES EXAMINED

ITEM
DESCRIPTION IN TARIFF TERMS SHOULD BE
NO

EXAMINATION RETURN
QTY

56 DATE RECEIVED
UNIT

UNIT VALUE

57 DATE RELEASED
TARIFF HEADING

1
PLEASE REFER TO RIDER/S FOR FINDINGS ON ITHER ITEMS
REVISED CHARGES
59 CHARGES

60 DECLARATION

61 FINDINGS

LIQUIDATION
62 DIFFERENCES

65 LIQUIDATION AMOUNT
PHP

DUTY
BIR Taxes

66 SHORT/EXCESS
PHP

VAT
Excise Tax/Ad

67 REMARKS

Others
Surcharges
TOTAL

63 ACTION DIRECTED /
RECOMMENDED

64
Date

68
Date
69

Date

CONTINUATION FROM BOX # 31

CUD
VAT

Date

FREE DISPOSAL

0.00
95,919.00

Total Item Taxes

IPF
D&F
CSF

95,919.00
1,000.00
265.00
234.00

Total Global Taxes

1,499.00
97,418.00

RATE

Republic of the Philippines

Department of Finance
BUREAU OF CUSTOMS

Terms Of Payment
Code

Account

010050011-3270780

Bank Reference Number :

Selectivity Color :

YELLOW

Section

Republic of the Philippines

Department of Finance
BUREAU OF CUSTOMS

TEMPORARY ASSESSMENT NOTICE

Customs Office

P07

Port of Cebu
Identification of the Declaration

Model

Ref
Year

Registration
Number
Date

Year

Number

2015

C-31397

2015

Declarant Reference No :

Nbr of
Items

1GTA1500181

Declarant : 936227663000

Importer :

11/17/15

Assessment
Day/Mth

004271857000

GEORGE B. CORTES
HIGHWAY 77 SAINT ANTHONY STREET TAL
AMBAN, CEBU CITY
CEBU 60006000
PHILIPPINES
AB
MAURI PHILIPPINES INC
3RD FLOOR UNIT 32 LEGASPI SUITES BL
DG.,SALCEDO ST., LEGASPIVILLAGE
MAKATI 1129
1129
PHILIPPINES

Mode of Payment :

CASH

Account Number

Receipt number

Statement number and date

CUD
VAT

0.00
95,919.00

Total Item Taxes

IPF
D&F
CSF

95,919.00
1,000.00
265.00
234.00

Total Global Taxes

1,499.00

Total assessed amount for the declaration

Amount currently to be paid

97,418.00

This temporary Assessment Notice provides advice to the declarant of the entry number assigned to the declaration
encoded. This document is of a temporary nature. The final Assessment Notice will be issued by BOC staff.

TRANSACTION RECEIPT

TRANSACTION RECEIPT NO.

CLIENT

TIN

1GTA1500181

AB MAURI PHILIPPINES INC

3RD FLOOR UNIT 32 LEGASPI SUITES BL
DG.,SALCEDO ST., LEGASPIVILLAGE
MAKATI 1129
1129
PHILIPPINES
004271857000

TRANSACTION DETAILS
ENTRY DATE

11/17/2015 00.00.00

ENTRY NO.

C-31397

HOUSE NO.

0395X05338

MANIFEST NO.

WHL0047-15

REFERENCE NO.

1GTA1500181

AMOUNT

45.00

TOTAL AMOUNT DUE

FORTY FIVE PESOS ONLY

Certified correct :
CARGO DATA EXCHANGE CENTER, INC.