TIOL-DDT 2181 · Tuesday, 3 September 2013 · story 3 of 9

INDIAN CUSTOMS DECLARATION FORM

(Please see important information given below before filling this Form)

1. Name of the Passenger…………….……………………………………………………………………………………………………………………

2. Passport Number …………………………………………… 3. Nationality ………………..………..

4. Date of Arrival ………………… (DD/MM/YYYY) 5. Flight No. ………………..………..

6. Number of Baggage …………………………………… 7. Country from where coming..………..

8. Countries visited in last six days ……………………………………………………………

9. Total value of dutiable goods being imported (Rs.) ……………………………………………..

10.; Are you bringing the following items into India? (please tick Yes or No)

(i)

Prohibited Articles

Yes / No

(ii)

Gold jewellery (over Free Allowance)

Yes / No

(iii)

Gold Bullion

Yes / No

(iv)

Meat and meat products/dairy products/fish/poultry products

Yes / No

(v)

Seeds/plants/seeds/fruits/flowers/other planting material

Yes / No

(vi)

Satellite phone

Yes / No

(vii)

Indian currency exceeding Rs. 7,500/-

Yes / No

(viii)

Foreign currency notes exceed US $ 5,000 or equivalent

Yes / No

(ix)

Aggregate value of foreign exchange including currency exceeds US $ 10,000 or equivalent.

Yes / No

Please report to Customs Officer at the Red Channel counter in case answer to any of the above question (not questions) is ‘Yes'.

Signature of Passenger ………………

Notification No. , Dated: August 29, 2013

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