ANDAMAN AND NICOBAR ISLANDS IMPORT/ EXPORT APPLICATION To The Port Authority Date: Port of Port Blair Working Place Per M.V. ............ Voy. No..........................Arrived from/Selling from ........... Dated ............ Shipping company/ Agent ..................... Delivery Order/ Shipping Order No. ............................Dated .......... Custom IFR/ EF No. ......................................Dated........... Line No. Mark No. of Pkgs Description of Cargo Weight/ Volume Value of Goods Certified that the above declaration pertaining to my consignment is correct: Payments / Advance for C.R.S enclosed. M/s ..................... Address .................. ........................ Signature of Importer/ Exporter with Seal/ Rubber Stamp FOR C.R.S SECTION USE ONLY Port Charges assessed under Notification No. GSR 428 (E) dated 1-4-1992 and Circular No. 5-1/90- TR dated 3-4-1991 Rs...............( Rupees ................................................... . ................................................... only ) WHARF SUPERINTENDENT (CRS) ROTATION No.