BOC SINGLE ADMINISTRATIVE DOCUMENT

1 DECLARATION Office Code P02B

2 Exporter / Supplier Address Manila Intl Container Port
4 4
1 HEBEI QINGEN TRADING CO., LTD.
HONGQI STREET INTERSECTION, 3 Page 4
Customs Reference
C 119695 04-25-2021
QIAOXI DISTRICT, SHIJIAZHUANG, 1 1 Registry Number EGP0046-21
C HEBEI PROVINCE CHINA 5 Items
1
6 Tot Pack
532
7 Reference Number
SAGT1042504
8 Importer / Consignee, Address TIN: 448175878000 9 CRF NUMBER :
U SRA AGGREGATES TRADING
4139 2ND STREET B ILAYA STO NINO T/S or W/S Entry No. :

PARANAQUE 1700
S PHILIPPINES 10 11 12 Tot. F/I/O (Php)
37,824.23
13 T. Ref.

14 Broker / Attorney-In-Fact, Address TIN: 296257160000 15 Country of Export 15 C.E. Code 17

T NOEL TARUC URBANO
201 LAURA ST. PUROK 4 AREA 5 OLD BA
CHINA CN PH

LARA QUEZON CITY 16 Country of Origin 17 Country of Destination

QUEZON CITY 1119
O PHILIPPINES CHINA PHILIPPINES
18 Vessel / Aircraft 19 Ct 20 Terms of Delivery
EVER ORIENT EGP0046-21 CIF
M 21 Local Carrier (if any) 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank
USD 9,072.88 48.402 2 X
S 25
4/21/2021
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 P02B
Manila Int'l Container Port S03
Bank Name

Branch
PCHC
NA Bank Ref Number: 010080502-0038111

31 Packages Marks and Numbers - Container No(s) 32 Item No. 33 HS Code Spec Code
and 1 39233090 000 000000
Marks & No N/M
Description of Packages 1X40 CTR 34 C.O. Code 35 Item Gross Weight (kg) 36 Pref
of Goods
Number and Kind 532 PK PACKAGE CN 7,520.00 ACFTA
Container No(s) EMCU1352425 37 Procedure 38 Item Net Weight (kg) 39 Qouta
- - Other
4000 000 7,144.00 NNNNN
Others
PLASTIC BOTTLE (BRAND: QINGEN) 40a AWB / BL 40b Previous Doc No.
EGLV149102789192
41 Suppl. Units 42 Item Customs Value (F. Cur) 43 V.M.

9,072.88 NV
44 Add Infos OTHinEV : 0 INSinFRT : 1 Fine :
Doc / Product A.I. Code 45 Adjustment
Certif. & 29,041.20 + 8,783.03 + 0.00 + 779.05 - 9,235.00
Aut 1.00
A.D.

46 Dutiable Value (PHP)

490,144.14
Invoice No. : 002D-1 Dump Bond :

47 Calculation Type Tax Base Rate Amount MP 48 Prepaid Account No. 49 Identification of Warehouse
of Taxes
/
CUD 490,144.14 5% 24,507.21 0
47b ACCOUNTING DETAILS
VAT 531,091.61 12 % 63,730.99 0
Method of Payment : CASH
Assessment Number : Date :

Reciept Number : Date :

Guarantee 0.00 Date :

Total Fees 1,264.00

Total Item: 88,238.20 Total Assessment 89,502.20

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
NOEL TARUC URBANO SRA AGGREGATES 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
53 INTERNAL REVENUE (TAX PER BOX #45 & #47)

TAXABLE VALUE PH 490,144.14 WHARFAGE 779.05 OTHERS 500.00

BANK CHARGES 0.00 TOTAL 531,108.08

ARRASTRE CHARGE 9,235.00
CUSTOMS DUTY 24,507.21 LANDED COST PH x 12%

BROKERAGE FEE 5,662.68 DOCUMENTARY STAMP 280.00 TOTAL VAT PH 63,730.99

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION 55 NO. OF PACKAGES EXAMINED 56 DATE RECIEVED 57 DATE RELEASED

EXAMINATION RETURN

58
ITEM TARIFF
NO DESCRIPTION IN TARIFF TERMS SHOULD BE QTY UNIT UNIT VALUE HEADING RATE

PLEASE REFER TO RIDERS FOR FINDINGS ON OTHER ITEMS

REVISED CHARGES LIQUIDATION

59 CHARGES 60 DECLARATION 61 FINDINGS 62 DIFFERENCES 65 LIQUIDATED Amount

Duty
BIR Taxes 66 SHORT/EXCESS
VAT
Excise Tax/Ad Valorem 67 REMARKS
Others
Surcharges
TOTAL
63 ACTION DIRECTED/RECOMMENDED 64 68

DATE COO III DATE

69

DATE COO V DATE

CONTINUATION FROM BOX # 31 FREE DISPOSAL CUD 24,507.21

Container Numbers continuation: VAT 63,730.99

Total Item Tax 88,238.20

IPF 500.00

CSF 484.00
CDS 250.00
IRS 30.00
Total Global Tax 1,264.00
89,502.20