Import Customs Declaration Form
Pharmaceuticals
Importer Details
Importer Name
Importer Address
Email
Phone
Shipment Details
Estimated Arrival Date
Port of Entry
Country of Origin
Mode of Transport
Air
Sea
Land
Pharmaceutical Product Details
Product Name
Generic Name
Manufacturer
Batch Number
Expiry Date
Quantity
Brief Description
Additional Information
Supporting Documents
Remarks
Declaration
I hereby declare that the above information is true and correct.