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SINGLE ADMINISTRATIVE DOCUMENT

1 DECLARATION Office Code: P02A


2 Exporter /Supplier Address Port of Manila
4 4 Manifest No: CCL0010-19
YANTAI XUTAI NEW ENERGY TECHNOLOGY CO., LTD
NO.229 SOUTH TONGSHI ROAD ZHIFU DISTRICT, YANTAI, 3 Page
Customs reference no.: C-40982
CHINA
1 1 Date : 03/27/2019 21:10:11
5 Items 6 Tot Pack 7 Reference Number

1 297 KZBB1900232
8 Importer/Consignee, Address Tin: 437659338000 9 CRF No.
MRSB TRADING
DOOR 3 LAKATAN ST. COR. PARK AVE JEREZA SUBD.
DAVAO CITY
8000
10 11 12 Tot. F/I/O 13 T. Rel.
PHILIPPINES
XX XX 1,336.40
14 Broker/Attorney-In-Fact, Address Tin: 455064225000 15 Country of Export 15 C.E. Code 17
WELJEEN ALASTRA MIRANDA
BLK. 7 LOT 1 KM.14 NEW AGUSTIN INDANGAN CHINA CN
DAVAO CITY 16 Country of Origin 17

CHINA
18 Vessel/Aircraft Registry No. 19 Ct 20 Terms Of Delivery
COSCO SURABAYA CCL0010-19 0 CIF
21 Local Carrier (If Any) : 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank

COSCO SURABAYA USD 11,220.00 52.801 2


25 26 27 Transhipment Port 28 Financial and Banking Data Bank Code : 998
XX Terms of Payment : 01-Basic
1
29 Port Of Destination 30 Location Of Goods Bank Name : PCHC
P02A-Port of Manila S01 Branch : NA Bank Ref No. : 010140015-0003594
Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Marks & Nos : NM
1 94054050000 7.00
No. Of Packages : 297
31 Packages 34 C.O. Code 35 Item Gross Wgt. 36 Pref
and Desc.
Of Goods
Number and Kind : CT-CARTON
CN 10,202.00 Kg(s)
Containers No(s) : 37 Procedure Item Net Weight 39 Quota
CAIU8947923
- - Other, of a kind used for lighting public open spaces or 000 10,202.00 Kg(s) NNNNN
thoroughfares 4000
40a AWB/BL 40b Previous Doc No.
MOBILE LIGHTING TOWER
SOLAR AND LED LIGHT COAU7058231790
OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value (F.C.) 43 V.M.
44 Add Infos
Doc / Produ.
1 0.000 0.00
Certif. & Aut.
1.00 11,220.00 1
58,715 + 11,849 + 0 + 347 - 1,122
45 Adjustment

Prev Doc Reference : 1.00


46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
P20190225PH 662,990.48
48 Prepaid Account No. 49 Identification of Warehouse
47 Calcula- Type Tax Base Rate Amount MP
tion of Taxes

CUD 662,990.48 7% 46,409.00 1 47b ACCOUNTING DETAILS


.............................................................................................................................
VAT 717,777.64 12% 86,131.00 1 Mode Of Payment
:
CASH
Assessment Number : L-49983 Date : 03/28/2019
Receipt Number : - Date :
Guarantee : Date :
.............................................................................................................................
Total Fees 1,558.00
Total
132,540.00 Total Assessment 134,098.00
50 We hereby certify that the information contained in all pages of this Declaration and the documents submitted are Subscribed and sworn to before me
to the best of out knowledge and belief true and correct.

WELJEEN ALASTRA MIRANDA MRSB TRADING Administering Officer /


Notary Public
Broker Date : Importer/Attorney-In-Fact

51 AUTHORIZATION 52 Control at Office Destination

Date Print name Position Date Print name Position

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
53 INTERNAL REVENUE (TAX PER BOX #46 & 47)

TAXABLE VALUE PHP 662,990.48 WHARFAGE 347.00 OTHERS 750.00


BANK CHARGES 0.00
ARRASTRE CHARGES 1,122.00 TOTAL LANDED COST PHP 717,777.21
CUSTOMS DUTY 46,409.00
5,878.74 DOCUMENTARY STAMP 280.00 TOTAL VAT PHP 86,131.00
BROKERAGE FEE

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION 55 NO. OF PACKAGES EXAMINED EXAMINATION RETURN 56 DATE RECEIVED 57 DATE RELEASED

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

PLEASE REFER TO RIDER/S FOR FINDINGS ON ITHER ITEMS

REVISED CHARGES LIQUIDATION

59 CHARGES 60 DECLARATION 61 FINDINGS 62 DIFFERENCES 65 LIQUIDATION AMOUNT


PHP
DUTY

BIR Taxes
66 SHORT/EXCESS
VAT PHP
Excise Tax/Ad
Valorem 67 REMARKS

Others

Surcharges

TOTAL

63 ACTION DIRECTED / 64 68
RECOMMENDED
Date Date

69
Date Date

CONTINUATION FROM BOX # 31 FREE DISPOSAL

CUD 46,409.00
VAT 86,131.00

Total Item Taxes 132,540.00

IPF 750.00
CDS 250.00
IRS 30.00
CSF 528.00

Total Global Taxes 1,558.00

134,098.00

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS

Terms Of Payment

Code Account

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
Bank Reference Number : 010140015-0003594 Selectivity Color : GREEN Section : 15
Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS
ASSESSMENT NOTICE

Customs Office P02A Port of Manila

Identification of the Declaration

Ref Registration Assessment Nbr of


Year Number Date Year Number Day/Mth Items
Model

4 4 2019 C-40982 03/27/19 2019 L-49983 28/March 1

Declarant Reference No : KZBB1900232


Declarant : 455064225000 WELJEEN ALASTRA MIRANDA
BLK. 7 LOT 1 KM.14 NEW AGUSTIN INDANGAN
DAVAO CITY

Importer : 437659338000 MRSB TRADING


DOOR 3 LAKATAN ST. COR. PARK AVE JEREZA SUBD.
DAVAO CITY
8000
PHILIPPINES

Mode of Payment : CASH Account Number

Receipt number and - Statement number and date


date :

CUD 46,409.00
VAT 86,131.00

Total Item Taxes 132,540.00

IPF 750.00
CDS 250.00
IRS 30.00
CSF 528.00

Total Global Taxes 1,558.00

Total assessed amount for the declaration


Amount currently to be paid 134,098.00

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
TRANSACTION RECEIPT

TRANSACTION RECEIPT NO. KZBB1900232

MRSB TRADING
CLIENT DOOR 3 LAKATAN ST. COR. PARK AVE JEREZA SUBD.
DAVAO CITY
8000
PHILIPPINES

TIN 437659338000

TRANSACTION DETAILS

ENTRY DATE 03/27/2019 00.00.00

ENTRY NO. C-40982

HOUSE NO. COAU7058231790

MANIFEST NO. CCL0010-19

REFERENCE NO. KZBB1900232

AMOUNT 45.00

TOTAL AMOUNT DUE FORTY FIVE PESOS ONLY

Certified correct :

CARGO DATA EXCHANGE CENTER, INC.

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