I affirm
that the information given above is true and correct. I
undertake to pay customs duty and GST on the liquors, tobacco
and motor vehicle included in my consignment, and also not
to dispose of used household articles and personal effects
within three months from the date of importation.
SIGNATURE:______________________________________________
NAME OF CLAIMANT:_______________________________________
PASSPORT NO.:___________________________________________
DATE: __________________________________________________
OCCUPATION: ____________________________________________
NAME
OF EMPLOYER: ______________________________________
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