CASCASCAS
[Paragraphs 8B.5(iii)]
Statement of export shipments made on charges collect basis and
repatriation of the funds involved for the month ended .......199
(To be submitted in duplicate)
Name of the freight forwarder: _____________________________________________________
Address & Phone No. ___________________________________________________________
___________________________________________________________
Part A Charges collect shipments sent
Sr.
No. | Name of the
overseas agent | Details of export shipments | Destination | Freight paid
to *shipping/
airline
company
Rs., | Charges to be
collected by
agent abroad
U.S.$ |
MAWB *
MBL No. & date/ | HAWB *
HBL No. & date |
(1) | (2) | (3) | (4) | (5) | (6) | (7) |
(i) | Shipments of earlier months for which payments were to be received at the beginning of the month |
| (1) | | | | | |
| (2) | | | | | |
| (3) | | | | | |
| (4) | | | | | |
(ii) | Shipments sent during the month |
| (1) | | | | | |
| (2) | | | | | |
| (3) | | | | | |
| (4) | | | | | |
Part B: Repatriation of charges collected
Sr.
No. | Name of the
overseas
agent | Details of export shipments | Destina-
tion | Charges
to be
collected
U.S.$ | Charges
received
U.S.$ | Date of
Receipt | BBA’s
fees
(6-7) |
MAWB *
MBL No. & date/ | HAWB *
HBL No. & date |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) |
| | | | | | | | |
Notes: (i) Copies of relevant MAWB/MBL & HAWB/HBL should accompany Part A
| |
Place: | Stamp | | (Signature of authorised official) |
| | Name: |
Date: | Designation: |
* Strike out whichever is not applicable.
Certificate from the Chartered Accountant
Certified that the particulars furnished above have been verified with reference to the books of account and bank certificate verified for the inward remittance received for the purpose as per column 7 above.
Place: Date: | | | | | | | | Signature : Status : Chartered Accountant Registration No.________________________ |