NA_CIFF

REPUBLIC OF NAMIBIA NAMIBIA CUSTOMS AND EXCISE

CLEARING AND FORWARDING INSTRUCTION FORM
NB: MUST BE COMPLETED AND SIGNED BY THE IMPORTER/EXPORTER.

1. IMPORTER/EXPORTER DETAILS:
IMPORTER\EXPORTER NAME : ULIENGUE NETO
POSTAL ADDRESS :
PHYSICAL ADDRESS : 610 NOKENG STREET
CONTACT PERSON : ULIENGUE NETO
TEL : .0817303000 FAX:
EMAIL : ARCANJO800@HOTMAIL.COM
VAT NUMBER : VAT IMPORT ACCOUNT NUMBER :
INVOICE NUMBER : 119013045

2. SHIPMENT DETAILS
VESSEL/VEHICLE NAME: REG NO/VOY NO: PORT OF LOADING: TIEL, THE NETHERLANDS

BILL OD LOADING NO: AIRWAY BILL NO: 5155057994 ROAD MANIFEST:

DESCRIPTION OFGOODS (HS Code): 4 PAIRS OF SNEAKERS

3. TYPE OF SHIPMENT
FCL LCL BREAK BULK CONTAINER NUMBER: X Other,kindly Specify: SHOES

4. CUSTOMS ENTRY INSTRUCTIONS

X Import CUSTOMS PROCEDURE CODE (CPC) X DESTINATION COUNTRY
X Export CUSTOMS PROCEDURE CODE (CPC)
X IM4: DIRECT IMPORT FOR HOME USE X NA: NAMIBIA
IM5 TEMPORARY IMPORT EX1: DIRECT EXPORT BW: BOTSWANA
IM6: RE-IMPORTATION EX2: DIRECT EXPORT LS: LESOTHO
IM7: WAREHOUSING EX3: DIRECT EXPORT ZA: SOUTH AFRICA
IM8: TRANSIT SZ: SWAZILAND
IM9: OTHER IMPORT PROCEDURES OTHER:

5. FINANCIAL INTELLIGENCE
The Financial Intelligence Act (Act No 13 of 2012) requires all importers to confirm the following:
a). Source of funds of your Business:
b). Source of funds for this transaction/shipment OWN

Party responsible for payment: ULIENGUE NETO

6. DELIVERY INSTRUCTIONS
MODE OF TRANSPORT: ROAD RAIL SEA COURIERS X OWN POST OFFICE
7. Authorization given by Importer/Exporter
I, ULIENGUE NETO ID no: N2345559 hereby give authority to the above clearing agency to
clear my consignment on my behalf.

Signature: Company stamp/Date: 27.07.2022

7. ACCEPTANCE BY CLEARING AGENT
I, an employee of the (Company Name):
Certify that I have the authority to clear the above mention consignment on behalf of my client.

Company stamp/Signature: