BOC IMPORT ENTRY & INTERNAL REVENUE

DECLARATION

Office Code:

1 DECLARATION

Manifest Number:

2 Exporter / Supplier, Address

Entry Number:

3 Page

Date:
5
8 Importer / Consignee ;
Address

TIN:

14 Broker / Attorney-In-Fact;
Address

TIN:

Registry

18 Vessel / Aircraft

19 Ct.

9a Freight

9b
Insurance

10

11

26

9c Other Dutiable Charges

13 Tentative

1
2

15 Country of
Export

16 Country of

17

17

15 C.E.
b

20 Terms of
Delivery
22 F. Cur.

21 Local Carrier (if

any)

7 Reference

6 Tot

23 Exch.
Rate

Total Customs
Value

28 Financial and Banking Data Bank

Code:

27 Transhipment

Terms of Payment
Bank Name:
31
Packages
and
Descr.

Branch:
32 Item
No.

Mark and Numbers Containers No(s) Number and Kind

Marks & No.
Of Packages
Number and Kind:

Bank Ref. Number:

33 H.S. Code
Tar. Spec.

34 C. O. Code

35 Item Gross

37
PROCEDURE

38 Item Net Weight

36 Pref.

KG

Containers No(s):

40a AWB /
BL.
44 Add.
Infos.
Dos. /
Produ.
Certif.
& Aut.

39
KG

40b Previous Doc.

41 Suppl.
Units

42 Item Customs Value (F.

Cur)

4
3

45
Adjustment

46 Dutiable Value
(PHP)

47
Calculation of
Taxes

Type

Tax
Base

Amoun
t

Rat
e

MP

49 Identification of

48

47b ACCOUNTING
DETAILS
Methods of Payment:

Total Fees:
Total

Total first item:

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

Broker

Date

Subscribed and sworn to

before me

Administering Officer /
Notary Public

Importer / Attorney-In52 Control at Office of

Destination

51

Date
S

Print Name

Date

Print Name

24