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EXPFORN,I

S[CONDORIGINAL
(Stalulo.y deciaral ori lo be furn shed by expoders
lTo bc rttuhcd l() the Aulh.rized Dc,lcr sirlrin
!fde. FE Requlaton Act. 1947 before shlomen(bf 1,1 days iorn tfic d.r. of shipmenl along *ith
aoods An rncotre.l decaraton constitutes oflence cuslor)s cerlllcatiM and relatile dooumcnt ibr

lr\l'\()
I 2- o I O o o S L q Lo l3
\tr,rr d xddress ollhcAutl'orized Dealer: SOCIALISLA|I BANK LIMITED
\\..r1,.!n(l.rrign.dhcr.b)declar.rlulhveanrirerhc,.lrrsLof.!, {.,l rhcgoo,rl(\9ilr!\lbclowinrespectolwhicl
Lli'il.r,fnLrorrrDrddcoulrudrharrhcfarriculaNsrve ,ntlrelol,,r ,g,,.,..,,.r*".,,ri{lrIlc nvoice vaiuc dcclarcd in
sl No.5 L clsc ol lirn connact is full valLrc as contraclcd wilh the buycrsi aDd in case ofconsignnrenl salc. is a fair valuc of
rhe Soods whjch are being shipped oi consigmnent sale.

L\!c (lo hcrcby undcllake ro r€pdrriure irll procccds oilhe cxpon \!ilhi. thc pdi(xl spcci{lc(l by the Bangladcsh Bank in

SI ParliculaN (1o be filled (lode No lr,) bc fillcd in


in by Exponcr) blAuthoriscd Dcrled

(rdr,,nil\ to tre cxporlcd KEY \!OVEN I'ROUSERS 62 0.1 2

TURKEY 1. 0 l
.t. Countiy ol-deslination

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lt CHITTACO\C PORT.
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Nrn,e ol r|. c\ton., (tn bl..k tclr.r) JERAT FASHION


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