Pae-House Air Waybill Master Air Waybill

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Master Air Waybill 695-25832155 House Air Waybill PAE- 1215337

Shipper's Name and Address Shipper's Account Number Not Negotiable House Air Waybill (Air Consignment note) Issued by

TCI Co., Ltd.-Biocosme PABP Branch


No. 21, Nongke Rd. Changzhi Township Pingtung County
90846 Taiwan R.O.C.
PHONE:02-87977811
萬萬萬萬萬萬萬萬萬萬萬
台台台台台台台台台台台台209號5F
Consignee's Name and Address Consignee's Account Number
5F, NO. 209, Sec. 3, Civic Blvd., Taipei, Taiwan
T 886-2-8772-5678 F 886-2-2776-5158
PT Jelita Anugerah Indonesia 航航航萬航航航航航航航號:航航貨1578號
Jl. Kaguk Kencana Blok C 12A, RT 03 RW 03, Kapuk Copies 1,2 and 3 of this Air Waybill are originals and have the same validity
Muara, Penjaringan, Jakarta utara, DKI Jakarta 14460
NPWP no.:85.096.979.1-047.000 It is agreed that the goods described herein are accepted in apparent good order and condition(except
as noted)for carriage SUBJECT TO THE CONDITIONS OF CONTRACT ON THE REVERSE HEREOF.
TEL:+62 818-0696-4997 ATTN:Budianto Dharmawan THE SHIPPER'S ATTENTION IS DRAWN TO THE NOTICE CONCERNING CARRIER'S LIMITATION OF
LIABILITY.Shipper may increase such limitation of liability by declaring a higher value for carriage and
paying a supplemental charge if required.
Issuing Carrier's Agent Name and City
Accounting Information

"FREIGHT PREPAID""DOOR TO DOOR SVC"

Agent's IATA Code Account No.

Airport of Departure(Addr.of First Carrier) and Requesting Routing

TAIWAN TAOYUAN INTERNATIONAL AIRPORT


To By First Carrier \ Routing and Destination / to by to by Currency Chgs. WT/VAL Other
Code PPD COLL PPD COLL
Declared Value for Carriage Declared Value for Customs

CGK BR 0237/APR. 9,2021 TWD PP PP PP N.V.D. N.C.V.


Airport of Destination Flight/Date Flight/Date Amount of Insurance NSURANCE- if carrier offers insurance and such insurance is requested
in accordance with conditions on reverse hereof indicate amount to be
JAKARTA,INDONESIA NIL insured in figures in box marked "Amount of Insurance"
Handling Information

Invoice, Packing List Attached

No.of
/
Gross kg. Rate Class Chargeable Rate Nature and Quantity of Goods
Pieces lb
Total
Weight Commodity Weight Charge (incl.Dimensions or Volume)
RCP Item No

1 182 1 M V.197 1 AS ARRANGED MASK

HS CODE:3304.99
PT Jelita Anugerah Indonesia
P/NO.01 "NOT RESTRICTED"
MADE IN TAIWAN
Q'TY:4,800.00PCS

INV NO:TA-8100022043

DIM:
L:117xW:101xH:100CM/1

\ Prepaid /\ Weight Charge /\ Collect / Other Charges

AS ARRANGED
\ Valuation Charge /

\ Tax /

\ Total Other Charges Due Agent / Shipper certifies that the particulars on the face hereof are correct and that insofar as any part of the consignment
contains dangerous goods , such part is properly described by name and is in proper condition for carriage by air
AS ARRANGED according to the applicable Dangerous Goods Regulations.
\ Total Other Charges Due Carrier /
AS ARRANGED PANDA AIR EXPRESS CO.,LTD.

Signature of Shipper or his Agent


\ Total Prepaid / \ Total Collect /
AS ARRANGED
\ Currency Conversion Rates / \ cc Charges in Dest.Currency / Apr. 09,2021 TAIPEI Jane
Executed on (Date) at (Place) Signature of Issuing
For Carriers Use only \ Charges at Destination / \ Total Collect Charges /
at Destination PAE- 1215337

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