Port Code SB No SB Date

INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24

CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - I - SHIPPING BILL SUMMARY

1.MODE 2.ASSESS 3.EXMN 4.JOBBING 5.MEIS 6.DBK 7.RODTP 8.LICENCE 9.DFRC 10.RE-EXP 11.LUT
STATUS

AIR N Y N Y Y Y N N N
A

12.PORT OF LOADING INBOM4 (Mumbai (Ex Bombay)) 13.COUNTRY OF FINALDESTINATION NETHERLANDS

14.STATE OF ORIGIN Goa 15.PORT OF FINAL DESTINATION AMS (AMSTERDAM, SCHIPHOL)

PY
16.PORT OF DISCHARGEAMS (AMSTERDAM, SCHIPHOL) 17.COUNTRY OF DISCHARGE NETHERLANDS
1.EXPORTER'S NAME & ADDRESS 7.CONSIGNEE NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD
B DECLARAN

PLOT NO.N2, PHASE IV, ARSENAAL 2 2

DETAILS

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL UTRECHT NETHERLANDS

CO
VERNA SALCETE GOA 2.Type Private NL
3. AD CODE: 6430004 8. GSTIN / TYPE 30AABCA8820A1ZI GSN
4.RBI WAIVER NO.& DT 9.FOREX BANK A/C NO. 36XXX018
5.CB NAME TRANSORION LOGISTICS SERVICES PVT10.DBK BANK A/C NO. 36XXX018
6.AEO 11. IFSC NO. BOFA0ND6216
1.FOB VALUE 2.FREIGHT 3.INSURANC 4.DISCOU 5.COM 1.DBK CLAIM 2. IGST AMT 3.CESS AMT
SUMMA
E MANIFEST C.VALU

EX.PR.
693673.46 0 0 0 0 6898 124861.23

D.
6.DEDUCTIONS 7.P/C 8.DUTY 9.CESS 4.IGST VALUE 5.RODTEP AMT 6.ROSCTL AMT
RT
0 0 693673.46 7746 0
1.MAWB NO. 2.MAWB DT 3.HAWB NO. 4.HAWB DT N.O.C. 1.SNO 2.INV NO. 3. INV AMT. 4.CURRENC
DETAILS

15767993236 E602983 F.INVOICE

1 AG0306097892 4654.29 USD
4. CIN NO. 5. CIN DT. 6. CIN SITE ID SUMMARY
2 AG0306097893 221.89 USD
24PCEG12191748734200 19-DEC-24 INBOM4 3 AG0306097894 46.23 USD
PO

1.CONTAINER 2.SEAL 3.DATE 4.S No 1SR.NO 2.CHALLAN NO 3.PAYMT DT 4.AMOUNT

CHALLAN DETAILS
G. EQUIPMENT
DETAILS

EX

H
T

1.SEAL TYPE 2.NATURE OF CARGO 3.NO. OF PACKETS 4.NO. OF CONTAINERS 5.LOOSE PACKETS
I. ANNEX
DETAILS

WAREHOUSE SEALED PACKAGED 4 0 4

LE

6.MARKS & NUMBERS WE INTEND TO CLAIM BENEFIT UNDER RODTEP SCHEME,SUPPLY MEANT FOR EXPORT ON PAYMENT
OF IGST UNDER CHAPTER VII ,16 3(B) OF THE INTEGRATED GOODS AND SERVICES TAX ACT, 2017

1.EVENT 2.DATE 3.TIME 4.LEO NO. 2/1523

J.PROCESS

5.Submission 13-DEC-24 10:13 6.LEO Date. 19-DEC-24

DETAILS

5.Assessment 8.BRC Realisation Date 30-SEP-25

7.Examination 19-DEC-24 20:23
9.LEO 19-DEC-24 21:13

10. SEZ UNIT Details

Signature Not Verified

Digitally signed by DS CENTRAL BOARD
OF INDIRECT TAXES AND CUSTOMS 08
Date: 2024.12.19 21:16:25 IST
Reason: CUSTOMS
Location: INDIA
Glossary
A: ASSESS - Assessed, EXMN - Examined, MEIS - Merchantise Export Incentive Scheme, DBK - Drawback, ROSL - Rebate of State Levies,
DEEC - Duty Exemption Entitlement Certificate, DFRC - Duty Free Replenishment Certificate,LUT - Letter of Under Taking. B: CB - Customs Broker
AD Authoized Dealer , AEO - Authorized Economic Operator, UCR - Unique Customs Reference C: DISCOU - Discount, COM - Commission,
P/C Packing Charges,D: EX. PR.- Export Promotions E: MAWB / HAWB - Master / House Airway Bill Number J:BRC- Bank Realisation Certificate

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Page 1 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - II - INVOICE DETAILS

1.S.No 2.INVOICE No. & Dt. 3.P.O.No. & Dt. 4.LoC No. & Dt 5.Contract No.&Dt 6.AD code 7.INVTERM
REF
A.

1 AG0306097892 12/12/2024 6430004 FOB

1.EXPORTER'S NAME & ADDRESS 2.BUYER'S NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD

Y
PLOT NO.N2, PHASE IV, ARSENAAL 2 2
B. TRANSACTION

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL

PARTIES

403722 UTRECHT NETHERLANDS

OP
3.THIRD PARTY NAME & ADDRESS 4.BUYER AEO STATUS

1.INVOICE VALUE

TC
2.FOB VALUE 3FREIGHT 4.INSURANCE5DISCOUNT6.COMMISON 7.DEDUCT 8.P/C 9.EXCHANGE RATE
C.VAL
DTLS

4654.29 4654.29 0 0 0 0 0 1 USD INR 83.9

USD USD USD USD
1.ItemSNo 2.HS CD 3.DESCRIPTION 4.QUANTITY 5.UQC 6.RATE 7.VALUE(F/C)
1 90011000 (MATERIAL ID:URXQPQPF8-MAM004) TELECOMMU 50 NOS 17.5142 875.71
NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8
OR
F-MPO8F,8F,2MM (FIBRE PATCH CORD-
2 90011000 (MATERIAL ID:URXQPQPF8-MAM005) TELECOMMU 45 NOS 19.2102 864.46
NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8
F-MPO8F,8F,2MM (FIBRE PATCH CORD-
3 90011000 (MATERIAL ID:URXQPQPF8-MAM002) TELECOMMU 30 NOS 15.5117 465.35
NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8
F-MPO8F,8F,2MM (FIBRE PATCH CORD-
4 90011000 (MATERIAL ID:URXQPQPF8-MAM003) TELECOMMU 50 NOS 16.5998 829.99
XP

NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8

F-MPO8F,8F,2MM (FIBRE PATCH CORD-
5 90011000 (MATERIAL ID:URXQPQPF8-MAM010) TELECOMMU 30 NOS 24.3043 729.13
NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8
F-MPO8F,8F,2MM (FIBRE PATCH CORD-
6 90011000 (MATERIAL ID:URXQPQPF8-MAM006) TELECOMMU 44 NOS 20.2193 889.65
TE

NICATION PRODUCTS - PC,ULL,LSZH,OM4,MPO8

F-MPO8F,8F,2MM (FIBRE PATCH CORD-
D. ITEM DETAILS

LE

Glossary
A: Ref - Reference P.O. - Purchase Order, LoC - Letter of Credit, AD - Authorised Dealer C: VAL DTLS - Valuation Details
FOB - Freight On Board, DEDUCT - Deduction , P/C - Packing Charge D: HS CD - Harmonized System Code, UQC - Unit Quantity Code

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Page 2 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - II - INVOICE DETAILS

1.S.No 2.INVOICE No. & Dt. 3.P.O.No. & Dt. 4.LoC No. & Dt 5.Contract No.&Dt 6.AD code 7.INVTERM
REF
A.

2 AG0306097893 12/12/2024 6430004 FOB

1.EXPORTER'S NAME & ADDRESS 2.BUYER'S NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD

Y
PLOT NO.N2, PHASE IV, ARSENAAL 2 2
B. TRANSACTION

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL

PARTIES

403722 UTRECHT NETHERLANDS

OP
3.THIRD PARTY NAME & ADDRESS 4.BUYER AEO STATUS

1.INVOICE VALUE

TC
2.FOB VALUE 3FREIGHT 4.INSURANCE5DISCOUNT6.COMMISON 7.DEDUCT 8.P/C 9.EXCHANGE RATE
C.VAL
DTLS

221.89 221.89 0 0 0 0 0 1 USD INR 83.9

USD USD USD USD
1.ItemSNo 2.HS CD 3.DESCRIPTION 4.QUANTITY 5.UQC 6.RATE 7.VALUE(F/C)
1 90011000 (MATERIAL ID:ANGLULUCD-J1M020) TELECOMMU 2 NOS 55.49 110.98
NICATION PRODUCTS - D-RFO, A-ULL,LSZH,TS ,
OR
LU-LU, 12F(2MM) (FIBRE PATCH CORD-
2 90011000 (MATERIAL ID:ANGLULUCD-J1M015) TELECOMMU 2 NOS 55.455 110.91
NICATION PRODUCTS - A-ULL,LSZH,TS, LU-LU ,
12F(2MM), 15MT (FIBRE PATCH CORD-
XP
TE
D. ITEM DETAILS

LE

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Page 3 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - II - INVOICE DETAILS

1.S.No 2.INVOICE No. & Dt. 3.P.O.No. & Dt. 4.LoC No. & Dt 5.Contract No.&Dt 6.AD code 7.INVTERM
REF
A.

3 AG0306097894 12/12/2024 6430004 FOB

1.EXPORTER'S NAME & ADDRESS 2.BUYER'S NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD

Y
PLOT NO.N2, PHASE IV, ARSENAAL 2 2
B. TRANSACTION

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL

PARTIES

403722 UTRECHT NETHERLANDS

OP
3.THIRD PARTY NAME & ADDRESS 4.BUYER AEO STATUS

1.INVOICE VALUE

TC
2.FOB VALUE 3FREIGHT 4.INSURANCE5DISCOUNT6.COMMISON 7.DEDUCT 8.P/C 9.EXCHANGE RATE
C.VAL
DTLS

46.23 46.23 0 0 0 0 0 1 USD INR 83.9

USD USD USD USD
1.ItemSNo 2.HS CD 3.DESCRIPTION 4.QUANTITY 5.UQC 6.RATE 7.VALUE(F/C)
1 90011000 (MATERIAL ID:ANGLULUCD-J1M010) TELECOMMU 1 NOS 46.23 46.23
NICATION PRODUCTS - A-ULL,LSZH,TS, LU-LU ,
OR
12F(2MM), 10MT (FIBRE PATCH CORD-
XP
TE
D. ITEM DETAILS

LE

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Page 4 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - II - INVOICE DETAILS

1.S.No 2.INVOICE No. & Dt. 3.P.O.No. & Dt. 4.LoC No. & Dt 5.Contract No.&Dt 6.AD code 7.INVTERM
REF
A.

4 AG0306097895 12/12/2024 6430004 FOB

1.EXPORTER'S NAME & ADDRESS 2.BUYER'S NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD

Y
PLOT NO.N2, PHASE IV, ARSENAAL 2 2
B. TRANSACTION

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL

PARTIES

403722 UTRECHT NETHERLANDS

OP
3.THIRD PARTY NAME & ADDRESS 4.BUYER AEO STATUS

1.INVOICE VALUE

TC
2.FOB VALUE 3FREIGHT 4.INSURANCE5DISCOUNT6.COMMISON 7.DEDUCT 8.P/C 9.EXCHANGE RATE
C.VAL
DTLS

133.81 133.81 0 0 0 0 0 1 USD INR 83.9

USD USD USD USD
1.ItemSNo 2.HS CD 3.DESCRIPTION 4.QUANTITY 5.UQC 6.RATE 7.VALUE(F/C)
1 85447090 (MATERIAL ID:FDWLALA21-JXF017) TELECOMMU 40 PCS 3.34525 133.81
NICATION PRODUCTS-JUMPER,PLENM,TS,1.6MM,
OR
SPLX,LA-APC/LA-APC (FIBRE PATCH CORD)
XP
TE
D. ITEM DETAILS

LE

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Page 5 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - II - INVOICE DETAILS

1.S.No 2.INVOICE No. & Dt. 3.P.O.No. & Dt. 4.LoC No. & Dt 5.Contract No.&Dt 6.AD code 7.INVTERM
REF
A.

5 AG0306097896 12/12/2024 6430004 FOB

1.EXPORTER'S NAME & ADDRESS 2.BUYER'S NAME & ADDRESS
COMMSCOPE INDIA PRIVATE LIMITED COMMSCOPE EMEA LTD

Y
PLOT NO.N2, PHASE IV, ARSENAAL 2 2
B. TRANSACTION

VERNA INDUSTRIAL ESTATE. Contact No 3905 NN VEENENDAAL-VEENENDAAL

PARTIES

403722 UTRECHT NETHERLANDS

OP
3.THIRD PARTY NAME & ADDRESS 4.BUYER AEO STATUS

1.INVOICE VALUE

TC
2.FOB VALUE 3FREIGHT 4.INSURANCE5DISCOUNT6.COMMISON 7.DEDUCT 8.P/C 9.EXCHANGE RATE
C.VAL
DTLS

3211.64 3211.64 0 0 0 0 0 1 USD INR 83.9

USD USD USD USD
1.ItemSNo 2.HS CD 3.DESCRIPTION 4.QUANTITY 5.UQC 6.RATE 7.VALUE(F/C)
1 85447090 (MATERIAL ID:FDWLALA21-JXF017) TELECOMMU 960 PCS 3.34546 3211.64
NICATION PRODUCTS-JUMPER,PLENM,TS,1.6MM,
OR
SPLX,LA-APC/LA-APC (FIBRE PATCH CORD)
XP
TE
D. ITEM DETAILS

LE

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Page 6 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
1 1 90011000 (MATERIAL ID:URXQPQPF8- 50 NOS 17.5142 875.71 73472.05 1616.39
MAM004) TELECOMMU
NICATION PRODUCTS -
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH

PY
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 73472.07 13224.97 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 1.293 KGS Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
1 2 90011000 (MATERIAL ID:URXQPQPF8- 45 NOS 19.21022 864.46 72528.19 1772.91
MAM005) TELECOMMU
NICATION PRODUCTS -
RT
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 72528.19 13055.07 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
PO

Drawback 1.368 KGS Goa SOUTH GOA

INVOICE (1/5)

24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
EX

1 3 90011000 (MATERIAL ID:URXQPQPF8- 30 NOS 15.51167 465.35 39042.85 1431.57

MAM002) TELECOMMU
NICATION PRODUCTS -
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
T

Y P 39042.87 7027.72 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
LE

Drawback .517 KGS Goa SOUTH GOA

24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

GLOSSARY
FOB - Freight On Board, HS CD Harmonized System Code, UQC - Unit Quantity Code, PMV - Present Market Value, CESAM - Cess Amount
IGSTSTA - IGST Payment Status, VAL - IGST Value, PAID - IGST Amount Paid, SCHCOD - Scheme Code, SQC MSR - Standard Quantity
Measurement, comp - compensatory, PT Abroad - Preferential treatment Availed Abroad

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Page 7 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
1 4 90011000 (MATERIAL ID:URXQPQPF8- 50 NOS 16.5998 829.99 69636.18 1532
MAM003) TELECOMMU
NICATION PRODUCTS -
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH

PY
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 69636.16 12534.51 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 1.089 KGS Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
1 5 90011000 (MATERIAL ID:URXQPQPF8- 30 NOS 24.30433 729.13 61174 2243.05
MAM010) TELECOMMU
NICATION PRODUCTS -
RT
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 61174.01 11011.32 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
PO

Drawback 1.089 KGS Goa SOUTH GOA

INVOICE (1/5)

24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
EX

1 6 90011000 (MATERIAL ID:URXQPQPF8- 44 NOS 20.21932 889.65 74641.62 1866.04

MAM006) TELECOMMU
NICATION PRODUCTS -
PC,ULL,LSZH,OM4,MPO8 F-
MPO8F,8F,2MM (FIBRE PATCH
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
T

Y P 74641.63 13435.5 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
LE

Drawback 19.938 KGS Goa SOUTH GOA

24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

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Page 8 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
2 1 90011000 (MATERIAL ID:ANGLULUCD- 2 NOS 55.49 110.98 9311.22 5121.17
J1M020) TELECOMMU
NICATION PRODUCTS - D-
RFO, A-ULL,LSZH,TS , LU-LU,
12F(2MM) (FIBRE PATCH

PY
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 9311.22 1676.02 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 1.215 KGS Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
2 2 90011000 (MATERIAL ID:ANGLULUCD- 2 NOS 55.455 110.91 9305.35 5117.94
J1M015) TELECOMMU
NICATION PRODUCTS - A-
RT
ULL,LSZH,TS, LU-LU ,
12F(2MM), 15MT (FIBRE PATCH
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 9305.35 1674.96 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
PO

Drawback .922 KGS Goa SOUTH GOA

INVOICE (2/5)

24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N
T EX
LE

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Page 9 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
3 1 90011000 (MATERIAL ID:ANGLULUCD- 1 NOS 46.23 46.23 3878.7 4266.57
J1M010) TELECOMMU
NICATION PRODUCTS - A-
ULL,LSZH,TS, LU-LU ,
12F(2MM), 10MT (FIBRE PATCH

PY
CORD-
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 3878.7 698.17 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 1.08 KGS Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100
RT Y Yes N
PO
INVOICE (3/5)

T EX
LE

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Page 10 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
4 1 85447090 (MATERIAL ID:FDWLALA21- 40 PCS 3.34525 133.81 11226.66 308.73
JXF017) TELECOMMU
NICATION PRODUCTS-
JUMPER,PLENM,TS,1.6MM,
SPLX,LA-APC/LA-APC (FIBRE

PY
PATCH CORD)
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 11226.66 2020.8 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 207.264 MTR Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100
RT Y Yes N
PO
INVOICE (4/5)

T EX
LE

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Page 11 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - III - ITEM DETAILS

1INVSN 2ITEMSN 3.HS CD 4.DESCRIPTION 5.QUANTITY 6UQC 7.RATE 8VALUE(F/C) 9.FOB (INR) 10.PMV
5 1 85447090 (MATERIAL ID:FDWLALA21- 960 PCS 3.34546 3211.64 269456.6 308.75
JXF017) TELECOMMU
NICATION PRODUCTS-
JUMPER,PLENM,TS,1.6MM,
SPLX,LA-APC/LA-APC (FIBRE

PY
PATCH CORD)
11.DUTYAMT 12.CESS RT 13CESAMT 14.DBKCLMD 15.IGSTSTAT 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
Y P 269456.6 48502.19 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 4974.336 MTR Goa SOUTH GOA

CO
24. PT Abroad 25.COMP CESS 26.END USE 27.FTA BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100
RT Y Yes N
PO
INVOICE (5/5)

T EX
LE

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Page 12 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - IV - EXPORT SCHEME DETAILS

A. DRAWBACK & ROSL CLAIM

1.INV SNO 2.ITEM SNO 3.DBK SNO. 4.QTY/WT 5.VALUE 6.RATE 7.DBK AMT 8.STALEV 9.CENLEV 10.ROSCTL AMT
1 1 9807900101B 50 73472.05 1 734.72 0 0 0
1 2 9807900101B 45 72528.19 1 725.28 0 0 0
1 3 9807900101B 30 39042.85 1 390.43 0 0 0
1 4 9807900101B 50 69636.18 1 696.36 0 0 0

Y
1 5 9807900101B 30 61174 1 611.74 0 0 0
1 6 9807900101B 44 74641.62 1 746.42 0 0 0
2 1 9807900101B 2 9311.22 1 93.11 0 0 0

OP
2 2 9807900101B 2 9305.35 1 93.05 0 0 0
3 1 9807900101B 1 3878.7 1 0 0 0 0
4 1 9807854401B 40 11226.66 1 112.27 0 0 0
5 1 9807854401B 960 269456.6 1 2694.57 0 0 0
B. AA / DFIA LICENCE DETAILS
1.INV SNO 2.ITEM SNO 3.LICENCE NO 4.DESCN OF EXPORT ITEM
TC 5.EXP SNO 6.EXPQTY 7.UQC 8.FOB VALUE
9.SION 10.DESCN OF IMPORT ITEM 11IMP SNO 12IMPQT 13.UQC 14.INDIG / IMP

C. JOBBING DETAILS
OTHER ADDITIONAL INFORMATION

1.BE NO 2.BE DATE 3.PORT CODE 4.DESCN OF IMPORTED GOODS 5.QTY IMP 6.QTY USED
OR

D. SINGLE WINDOW DECLARATION

1.INVSN 2.ITMSN 3.INFO 4.QUALIFIER 5.INFO CD 6.INFO TEXT 7.INFO MSR 8.UQC
1 1 DTY RDT RODTEPY Claimed 1.293 KGS
1 1 DTY GCESS 0 INR
XP

1 1 ORC EPT NCPTI

1 1 CHR SQC 1.293 KGS
1 1 ORC STO 30
1 1 ORC DOO 552
1 2 DTY GCESS 0 INR
1 2 DTY RDT RODTEPY Claimed 1.368 KGS
TE

1 2 ORC EPT NCPTI

1 2 CHR SQC 1.368 KGS
1 2 ORC DOO 552
1 2 ORC STO 30
1 3 ORC EPT NCPTI
1 3 DTY GCESS 0 INR
1 3 DTY RDT RODTEPY Claimed .517 KGS
LE

1 3 CHR SQC .517 KGS

1 3 ORC STO 30
1 3 ORC DOO 552
1 4 DTY GCESS 0 INR
1 4 DTY RDT RODTEPY Claimed 1.089 KGS
1 4 ORC EPT NCPTI
1 4 CHR SQC 1.089 KGS
1 4 ORC DOO 552
1 4 ORC STO 30
1 5 ORC STO 30
1 5 DTY RDT RODTEPY Claimed 1.089 KGS
1 5 CHR SQC 1.089 KGS
1 5 ORC EPT NCPTI
1 5 DTY GCESS 0 INR
1 5 ORC DOO 552
1 6 ORC STO 30
1 6 DTY RDT RODTEPY Claimed 19.938 KGS
1 6 DTY GCESS 0 INR
1 6 ORC EPT NCPTI
1 6 CHR SQC 19.938 KGS
Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla

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Page 13 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - IV - EXPORT SCHEME DETAILS

D. SINGLE WINDOW DECLARATION

1.INVSN 2.ITMSN 3.INFO 4.QUALIFIER 5.INFO CD 6.INFO TEXT 7.INFO MSR 8.UQC
1 6 ORC DOO 552
2 1 DTY RDT RODTEPY Claimed 1.215 KGS
2 1 DTY GCESS 0 INR
2 1 ORC EPT NCPTI

Y
2 1 CHR SQC 1.215 KGS
2 1 ORC STO 30
2 1 ORC DOO 552

OP
2 2 ORC DOO 552
2 2 ORC STO 30
2 2 CHR SQC .922 KGS
2 2 ORC EPT NCPTI
2 2 DTY GCESS 0 INR
2 2 DTY RDT
TC RODTEPY Claimed .922 KGS
3 1 ORC EPT NCPTI
3 1 DTY RDT RODTEPY Claimed 1.08 KGS
3 1 CHR SQC 1.08 KGS
3 1 ORC STO 30
3 1 DTY GCESS 0 INR
3 1 ORC DOO 552
OTHER ADDITIONAL INFORMATION

4 1 ORC STO 30
OR

4 1 ORC DOO 552

4 1 CHR SQC 207.264 MTR
4 1 ORC EPT NCPTI
4 1 DTY GCESS 0 INR
4 1 DTY RDT RODTEPY Claimed 207.264 MTR
5 1 ORC STO 30
5 1 ORC DOO 552
XP

5 1 DTY RDT RODTEPY Claimed 4974.336 MTR

5 1 ORC EPT NCPTI
5 1 CHR SQC 4974.336 MTR
5 1 DTY GCESS 0 INR
E. SINGLE WINDOW DECLARATION - CONSTITUENTS
TE

1.INVSN2.ITMSNO 3.C SNO 4.NAME 5.CODE 6.PERCENTAGE 7.YIELD PCT 8.ING

F. SINGLE WINDOW DECLARATION - CONTROL

1.INVSN2.ITMSNO 3.CONTROL TYPE 4.LOCATION 5.ST DT 6.END DT 7.RES CD 8.RES TEXT
LE

G.SUPPORTING DOCUMENTS
1.INVSN2.ITMSNO 3 DOCTYPCD 4. ICEGATE ID 5. IRN 6.PARTY CD 7.ISSUE PLA 8.ISS DT 9.EXP DT
1 0 934000 MERITMAA1 2024121300005739 SOUTH GOA 12-DEC-24
1 0 331000 MERITMAA1 2024121300005740 SOUTH GOA 12-DEC-24
2 0 331000 MERITMAA1 2024121300005741 SOUTH GOA 12-DEC-24
3 0 331000 MERITMAA1 2024121300005742 SOUTH GOA 12-DEC-24
4 0 331000 MERITMAA1 2024121300005743 SOUTH GOA 12-DEC-24
5 0 331000 MERITMAA1 2024121300005867 SOUTH GOA 12-DEC-24
H.INVOICE DETAILS
1.SNO 2.INVOICE NO 3.INVOICE AMOUNT 4.CURRENCY
1 AG0306097892 4654.29 USD
2 AG0306097893 221.89 USD
3 AG0306097894 46.23 USD
4 AG0306097895 133.81 USD
5 AG0306097896 3211.64 USD
I.CONTAINER DETAILS
1.SNO 2.CONTAINER 3.SEAL 4.DATE

Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla

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Page 14 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - IV - EXPORT SCHEME DETAILS

J.AR4 DETAILS
1.INVSN 2.ITMSN 3.AR4 NUMBER 4.AR4 DATE 5.COMMISSIONERATE 6.DIVISION 7.RANGE

K. THIRD PARTY DETAILS

1.INVSN 2.ITMSN 3.IEC 4. EXPORTER NAME 5. ADDRESS 6.GSTN ID AND TYPE

Y
L. ITEM MANUFACTURER/PRODUCER/GROWER DETAILS

OP
1.INVSN2.ITMSN 3.TYPE 4.MANUFACT CD 5.SOURCE STATE 6.TRANS CY 7.ADDRESS

M. RODTEP DETAILS
1.INVSN2.ITMSN 3. QUANTITY 4. UQC 5. NO. OF UNITS 6. VALUE
1 1 1.293 TC KGS 1 1029
1 2 1.368 KGS 1 1015
1 3 .517 KGS 1 547
1 4 1.089 KGS 1 975
1 5 1.089 KGS 1 856
1 6 19.938 KGS 1 1045
2 1 1.215 KGS 1 130
OTHER ADDITIONAL INFORMATION

2 2 .922 KGS 1 130

OR

3 1 1.08 KGS 1 54
4 1 207.264 MTR 1 79
5 1 4974.336 MTR 1 1886
N. REEXPORT DETAILS
1.INVS 2.ITMSN 3.BE SITE ID 4.BE NUMBER5.BE DATE6.BE INV SNO 7.BE ITEM S 8. BE QTY 9. BE UQC
XP
TE
LE

Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla

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Page 15 Of 16
 Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INBOM4 6408767 13-DEC-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 1797000683 0
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 30AABCA8820A1ZI GSN
GOVERNMENT OF INDIA CB CODE AAICM1005ECH007
TYPE INV ITEM CONT
Nos 5 11 0
AIR CARGO COMPLEX, SAHAR, ANDHERI(E) MUMBAI 400099 PKG 4 G.WT KGS 98.8 * SB22191220242114

PART - V - DECLARATIONS

Y
OP
TC
A. DECLARATION STATEMENT

OR
XP
TE
LE
B. AUTHORIZED
SIGNATORY

DATE AUTHORIZED SIGNATORY CHA NAME :AAICM1005ECH007

PLACE

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Page 16 Of 16