ae ee Oa UNACCOMPANIED BAGGAGE DECLARATION FORM PassengerName: ‘Adress = city ‘States Pin Code = = Phone No (CHA/SELF) AAAFD332iPCHOOL Nationality: Date of shipment of goods: Passport no: Passport valid up to [Country of consignment: Pit of shipmer | Any shorts (yes/no}during the preceding ‘wo.years (for TR/MTR/NTR) - Ifyes above detalls of shore visit From date ( date of arrival in india ‘To date date of departure fromingia) oa | Date of departure from india Daterof arrival in India + a | Baggage type ( TR/MIR/NTR | ‘Weather you have availed Rin past yes/no. IGMNO: \GM DATE: IF yes, Date of avallment of TR | INVERT Date: [MBLNo: [MBL DATE? iy HBLNO: MBLDATE: =| Sea igibipackapese Grass Weight? ‘Container no + Sealno: SR.NO/ITEM DESCRIPTION [BRAND |QTY [UNIT J UI 1 | PRICE | CoDI ie ead ae [ L ‘TRtransfer Residence / NTR— Non Transfer Residence / MTR 2M , Residence Pl Attach Extra sheet if required. 2 > 'hereby declare that the praticulars given above are true andi‘ITEM DESCRIPTION BRAND UNIT PRICE UNIT CODE TOTAL VALUE fs eles] sl 3] B] Bye a Gl S| ar y BD Began betitDate: 23.06.2023 To, Navio Shipping Pvt. Ltd. Mumbai Maharashtra Dear Sir, Sub: Authority Letter for Collection of Delivery Order Ref: HBL NO OC/NHV/0617 / Dtd. 22.05.2023 | Mayur Ramchandralal Gupta hereby authorize to collect the delivery order for the clearance of our import consignment from UBC. Kindly do the needful and oblige. Thanking you, Yours faithfully, Cagle Mayur Ramchandralal Gupta Passport No.: 24505344 Date of Issue: 14.12.2020Date:23.06.2023 To, The Assistant Commissioner of Customs. Customs House JNPT/MUMBAIV/ACC. Mumbai Dear Sir, ‘Sub: Authority Letter for Clearance of Import Consignments Ref:HBL NO OC/NHV/0617/ Dtd. 22.05.2023 IMayur Ramchandralal Guptahereby authorize as our clearing and forwarding agent for the clearance of our import consignments for the said shipment. We are enclosing herewith full set of import documents with copy of other relevant documents required for the clearance of our above said consignment. We certify that the shipment does not contain any contraband goods such as gold and gold jewellery, silver or silver articles or any such articles. Kindly do the needful and oblige. Thanking you, Yours faithfully, Mayur Ramchandralal Gupta Passport No.: 24505344. Date of Issue: 14.12.2020NOTE : THIS FORM IS MANDATORY TO FILLED. QUESTIONNAIRE (CLIENT NAME: DUTY FREE ITEMS ONLY 1 INTR PKGSNO, [ITEM ‘MAKE VAL HOWOLD M/OVEN W/Machine C/Range Music System Fridge below 300 Lars, ‘Computer/Laptop ANNEX II DUTY @ 16.5% HOME THEATER FRIDGE ABOVE 300 LTRS VIDEO CAMERA DISAWASHER DUTYABLE ITEMS @ 38.5% TV (NEW/OLD) NEW FURNITURE | NEW HOUSE HOLD ITEM "ANY REPEATED ELECTRONICS ITEM WILLBE CHARGED ON 38.5% 1) Do you want to clear the shipment under Transfer of Residence (iFeligible) YES No: 2). PLEASE MENTION IF THERE IS/ARE ANY LIQUOR BOTTLES /WINE BOTTLES /CIGARETTES IN YOU ‘SHIPMENT. 3) IF YES THEN PLEASE MENTION THE QUANTITY ( BOTTLES/PACKETS) SIGNATURE My otDate: 23.06.2023, To, Navio Shipping Pvt. Ltd. Mumbai Maharashtra Dear Sir, Sub: Authority Letter for Collection of Delivery Order Ref: HBL NO OC/NHV/0617 / Dtd. 22.05.2023 | Mayur Ramchandralal Gupta hereby authorize to collect the delivery order for the clearance of our import consignment from UBC. Kindly do the needful and oblige. Thanking you, Yours faithfully, Mayur Ramchandralal Gupta Passport No.: 24505344 Date of Issue: 14.12.2020Know Your Customer (KYC) Form for CHA - Individuals - Name: u/s Date of Birth Tue 198) Sex Male. Present Address: 6ja9. Give Hovsnmg _secroR S/H Cutan —Telephime —Dechonge, _Ehuiragas — 3e400r a pannumber AEC PG 7655 RK tecnumber Telephone Mobile 982520627 [ 104622 0660 Fax Email —whtygula 32 gamaib to 70 Permanent Address: 6/32 aunc. Hovenog. Ceccron , Bit CHITEN Telaprons Exchorp ; Bhavrayas 364004 a ‘Telephone O278-2A4621F Movie © _ S SSF TE os Fax Email inp 3 Oy Mma: Com Documents Required EX Passport Pan card 1 Voters identity Card Di Diiving License 1 Bankstatement Di ation card Note: Any two ofthe documents listed above, which provides clent/ customer information to the satisfaction of the CHA will suffice, Know Your Customer 00) Fm for nds & Soft tative ‘Pesce ng ded pol ell Sp Ct Wh epee acpi a he eran prt Ca co eR cna ot ae on th peso not nananonnnog te unre need eae ams edo n taf anno oa aap eeeName of Passenger / Passengers Date: To, ‘The Dy/ASSTT.Commissioner of Customs Un-Accompanied Baggage Cenre INCH (Speedy CFS}/Mumbai Port Trust (1U/C WH) Air Cargo Complex (ACC) Nhava Sheva / Sahar (Andheri) /Mumbai UNDERTAKING / AUTHORITY AND DECLARATION Dear Sir, Sub: Clearance of my. Packages containing Personal & Household goods under Transfer of, Residence {TR} / Mini TR {MTR} / Vistt {NTR} arciving from, by Sea / Air per ss /Flight Vide BL # / AWB #. dtd In reference to the above to the above subject | am holding passport # valid up to arrived at Airport from after a stay of more than years. | was working / staying in ‘and returning to India because of, hereby Authorize my Customs Broker M/s. (co-11/ }to clear ‘and deliver my above said Un-Accompanied Baggage on below said address after completing all necessary Customs and CFS — Nhava Sheva/MBPT -Mumbai Port / IAAI ~ Sahar Airport farmalities on my behalf. |/ We declare that the Contents and the value of my Household Articles are as per the list mentioned on the reverse side. | further declare that { have not availed any benefit of TR/MTR in last 3 years. | have/have not availed any benefit vide BD No, dr, | undertake that in case of any wrong declaration found against me or any Concealed, Contraband, Prohibited, Excess or mis-deciared Articles are found in my Un-Accompanied Baggege, then | shal solely be responsible for any action taken by Customs or any Government Authority and be liable to pay Customs Duty /Penalty/Fine and /or Confiscation of gocds that may be imposed by the authorities. have also agreed to pay all the charges to my Customs Broker towards clearance & Delivery including. their Agency and Attendance Fees prior to the final delivery of the goods at my residence, Thanking You, Delivery Address Yours Faithfully, of Passenger / Authorized Person. SignatureCLIENT NAME : PACKAGE NO | ITEM. MAKE VALUE 1. Do you want to clear the shipment under Transfer of Residence ( ifeligible) Yes No 2. Please mention if there is / are any Liquor Bottles / Wine Bottles / Cigarettes in your shipment. 3. Ifyes, then please mention the quantity ( Bottles/Packets) Signature Haale