[Paragraph8B.3]
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Particulars of (A) on carriage, agency commission, etc. charges to be remittedabroad and (B) Payments on oceanfreight/slot-hire charges made to shipping companies in India in respect of export cargo(es) for the period from to
Name & address of the MTO
Address
Registration No.
Validity of Registration upto
Sr
MTD@
Freight
Sr.No. of the
Name of the
No.
Date
Pre-paid
To collect
container
Transhipment
Agent
Port
1.
2.
3.
4.
5.
6.
7.
8.
TOTAL:
Port of
Place of
On carriage
Agency
Other
Total
discharge and
delivery
By Mode
Charges in
commission
charges
(12+13+14)
name of agent
*
foreign
appointed
currency
9.
10.
11.
12.
13.
14.
15.
Sr.
Name of the shipping
Voyage No.
Date of
company
agent in India
vessel
sailing
Sr.No. of the containers
Name of the Hub Port/
Ocean freight/ slot-hire paid
FCL
LCL
transhipment port
Amount (Rs.)
We hereby certify that the information contained in this statement is true and correct in every respect and gives complete information of export containers handled by us and remittances effected.
Place:
Date:
Stamp
(Signature of Authorised Official)
We certify having allowed the remittance of
on
(item 15 of Part A)
Name
Designation
@
Adseriatim (all MTOs issued during the month)
Ocean, rail, road, Inland waterways etc.