Import Customs Declaration Form for Chemicals
1. Importer Information
Importer Name
Company Name
Address
Contact Number
Email
Import/Export License No.
2. Shipment Information
Port of Entry
Date of Arrival
Country of Origin
Bill of Lading / Airway Bill No.
3. Chemical Description
Chemical Name
CAS Number
Quantity
Unit
HS Code
Packing Type
Purpose of Import
Details of End Use
4. Declaration
Name of Declarant
Signature
Date
Remarks / Additional Information