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53 INTERNAL REVENUE (TAX PER BOX # 46

& 47
TAXABLE VALUE

PHP

OTHERS

WHARFAGE

TOTAL
LANDED COST

BANK CHARGE

PHP

ARRASTRE CHARGES
CUSTOMS DUTY
DOCUMENTRAY STAMP

BROKERAGE FEE

55 NO OF PACKAGES
EXAMINED

54
SECTION

58

ITE
M
NO

X
%
TOTAL VAT

56 DATE
RECEIVED

EXAMINATION RETURN

DESCRIPTION IN TARIFF TERMS, SHOULD


BE

QTY.

UNIT

PHP

57 DATE RELEASED

UNIT
VALUE

TARIFF
HEADING

Decl.

Fdg
s.
%

PLEASE REFER TO RIDER/S FOR FINDINGS ON


OTHER ITEMS

REVISED
59

CHARGES

60

DECLARATIO
N

61

LIQUIDATION
FINDINGS

62

DIFFERENCES

Duty

65 LIQUIDATED
AMOUNT
PHP
66
SHORT/EXCESS

BIR Taxes

PHP
67 REMARKS

VAT
Excise Tax / Ad
Valorem
Others
Surcharges
63 ACTION DIRECTED /
RECOMMENDED

64

68
DATE
DATE

COO III
COO V

DATE
69

COO III

COO V

CONTINUATION FROM BOX


# 31

FREE DISPOSAL

RATE