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SAD 501 - CUSTOMS DECLARATION FORM Office Code 3. Forms Registation No and Date 7.

Declarant Reference
1. Importer or Exporter TIN 21319670 KOM 2 4 6609 EXP10112
ARLINDO ADRIANO NGUENHA
31. Marks and 32. Item No. 33. Commodity Code
Packages Numbers
and
Description Numbers & Type 34. COC 35. Gross Mass (KGS) 36. Preference
of Goods of Packages ZA
Container 37. COC 38. Nett Mass (KGS) 39. Quota
Numbers 60 ,00
Description 40. Summary Declaration / Previous Document
8340 kg ton truck, toyota hino
41. Supp. Units 42. Customs Value 43. V.M
1.00 NO (FCY)

260869.57
44. Licence Number Detected Value Deducted Quantity Ex Warehouse Code 45. Other Quantities
Additional
Information/
1
Produced Removal in Bond (R.I.B) & Date Rebate Code 46. Statistical Value
Documents
31. Marks and 32. Item No. 33. Commodity Code
Packages Numbers
and
34. COC 35. Gross Mass (KGS) 36. Preference
Description Numbers & Type of
of Goods Packages ZA
Container 37. COC 38. Nett Mass (KGS) 39. Quota
Numbers
Description 40. Summary Declaration / Previous Document
AS ADDRESSED 1xUSED TOYOTA HINO
41. Supp. Units 42. Customs Value 43. V.M
1.00 NO (FCY)

44. License Number Deducted Value Deducted Quantity Ex Warehouse Code 45. Other Quantities
Additional
Information/

Produced Removal in Bond (R.I.B) & Date Rebate Code 46. Statistical Value
Documents

31. Marks and 32. Item No. 33. Commodity Code


Packages Numbers
and 34. COC 35. Gross Mass (KGS) 36. Preference
Numbers & Type
Description
of Packages
of Goods
37. COC 38. Nett Mass (KGS) 39. Quota
Container
Numbers
Description 40. Summary Declaration / Previous Document
8340 kg ton truck, toyota hino
41. Supp. Units 42. Customs Value 43. V.M
(FCY)

44. License Number Deducted Value Deducted Quantity Ex Warehouse Code 45. Other Quantities
Additional
Information/
Produced Renoval in Bond (R.I.B) & Date Rebate Code 46. Statistical Value
Documents
47. Type Duty/Tax Base Rate Amount MP Type Duty/Tax Base Rate Amount MP
Calculation
of Duties
and
Taxes
TOTAL ON FIRSTITEM OF THIS PAGE TOTAL ON SECOND OF THIS PAGE
Tape Duty/Tax Base Rate Amount MP Type Amount MP
CD 0.00
GRAND TOTALS
TOTAL ON THIRD ITEM OF THIS PAGE 0.00
FOR ALL PAGES

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