Customs Series Form No. 107A
Form Courier Bill of Entry-IV (CBE-IV)
Courier Bill of Entry for Sample and Free Gifts
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Name & Address of the Authorized Courier
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Airport of Arrival
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Flight No.
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Date of Arrival
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Airport of Shipment
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Custom Serial No. and date
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| SI. No. |
AWB No. |
No of packages |
Consignees Name & Address |
Description of goods |
Qty. |
| Invoice Value |
Rate of Exchange |
Assessable Value(Sec.14) |
CTH/Notfn No. |
Duty |
Declaration
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I/We hereby declare that I/we have obtained the authorization from each of the consignees mentioned above to act as an agent for the clearance of the goods described above.
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I/We hereby declare that the goods imported as per this Bill of Entry include only bonafide commercial samples, prototypes of goods and bonafide gifts of articles for personal use of a value not exceeding 1 [Rs. 5.000] and which are for the time being not subject to any prohibition or restriction on their import into India.
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I/We enclose herewith........... (number) of airway bills and ................(number) of invoices for the aforesaid consignments with this Bill of Entry.
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I/We hereby declare that the contents of this Bill of Entry are true and correct in every respect and are in accordance with the Airway Bills. the invoices and other documents attached herewith.
Signature and Stamp of
Authorized Courier.
Signature of Assessing Officer
Signature of Audit Officer
(Passed out of customs Charge)
Signature of proper Officer.