Import Customs Declaration Form
Industrial Raw Materials
Importer Information
Importer Name
Address
Tax Identification Number
Contact Person
Phone
Email
Shipment Details
Invoice Number
Invoice Date
Country of Origin
Port of Entry
Expected Arrival Date
Raw Materials Item List
Description
HS Code
Quantity
Unit
Value (Currency)
Declaration
I hereby declare that the above information is complete and accurate.
Declarant Name
Title/Position
Date
Signature