Republic of the Philippines
DEPARTMENT OF TRADE AND INDUSTRY
Cebu Provincial Office 3/F LDM Building, Legaspi Street, Cebu City
Phone: (6332) 2557084, 2557086 Fax: (6332) 2557609

APPLICATION FOR IMPORT COMMODITY CLEARANCE
(Please submit one copy)

The Regional Director
Bureau of Product Standards
Department of Trade and Industry
Region VII, Cebu City

Sir :

        In accordance with Section 6 of Republic Act 4109 and in conjunction with Letter of Instruction No. 1208 and the Memorandum re: Mandatory Philippine National Standards, we hereby apply for an Import Commodity Clearance of our incoming shipment.

1. Name of Applicant Firm
:
2. Office Address / Tel. No. :
3. Warehouse Address / Tel. No. :
4. Product Imported :
5. Brand Name

:

6. Type/Capacity/Grade :
7. Quality/Volume of Import :
8. Value of Import :
9. Country of Origin :
10. Name of Exporter :
11. Address of Exporter :
12. Port of Discharge :
13. Vessel / Air Carrier :
14. Voyage / Flight No. :
15. Import Entry No. :
16. Bill of Lading / Airway Bill No. :
17. Name of Duly Authorized Rep. :
18. Position of Duly Authorized Rep. :
19. Address and Tel. No. Duly Authorized Rep :


20. Attachments:

  1. Import Entry / Special permit to Transfer
  2. Invoice
  3. Bill of Lading / Airway Bill
  4. Packing List
  5. SGS (Clean Report of Findings)
  6. Special Power of Attorney of Duly Authorized Rep.
  7. Certificate of Quality from the recognized standards body of the country of origin

    It is hereby certified that the information supplied herein by the undersigned is true and correct.
              

 

________________________________
Printed Name & Signature of Importer /
Authorized Representative of Importer

              Subscribed and sworn to before me this of , 20 affliant exhibiting to me his/her Residence Certificate A/B No. _______________ issued at _________________________________ on________________, 1999

 

 

________________________________
Notary Public                          

 

 

Doc No. ________
Page No. _______
Book No. _______
Series of 1999


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