BD0010990 Co Code

Name and address of the Authorised Dealer effecting the remittance:Prime Bank Ltd. PRIME BANK LTD., HO, TSD
I/We, the undersigned hereby apply for permission to remit: USD 37026
TOYO INK PTE LTD, 63 JOO KOON CIRCLE, SINGAPORE, 629076,TEL:(65)68636290, FAX:(65)68636296
(Amount in foreign currency in figures and in words)
(Name and address of the beneficiary)
for goods imported/to be imported by me/us as per details given below.
84167 FLEXO
GRAVURE
PRINTING IN
32151910 KG 16000 37060 SINGAPORE
Number Date Value in
Taka
Registration
No. with the
AD
L.C. Authorisation Form Description
of Goods
I.T.C./
H.S
Code No.
Unit Quantity
Quantity of
Goods
Invoice Value
in Foreign
Currency
(f.o.b/cfr/cpt/c
if)
Country
of
Origin
1 2 3 4 5 6 7
SINGAPORE STEAMER CHITTAGONG BD0010128
Port of
Shipment
Name of
Steamer/Air
Line and date of
Shipment (if goods
are sent by post st
Port of importation
in Bangladesh or
name of country of
ultimate destination
if other than Banglad
Indentor's Name
and Address
C.C.I & E. Bangladesh Bank
Indentor's Registration No.
with
8 9 10 11 12
Full name and address of
the applicant:
MAYSHA TRADERS
01 NEW ESKATON ,DILU ROAD
DHAKA-1000
Per pro ______________________
Signature and Stamp of the Importer
Registration No. with C.C.I.&E.:
This form shall be signed by the
Importer or his authorised Agent
(To be completed by the authorized Dealer)
1. We hereby certify that the statements made by the applicant in this form are to the best of our
knowledge correct and that we have seen documentary evidence in support thereof.
2. The remittance has been made in accordance with method of payment as per existing Exchange
Control Regulations:
Date:
Signature and stamp of Authorised Dealer
See Chapter 7 Para 28(a)
IMP. NO. PBL A.D's code Serial No. Year
APP.5 11
Form - IMP
For Imports only
FOREIGN EXCHANGE REGULATION ACT, 1947
Application for Permission under Section 4/5 of the Foreign Exchange Regulation Act, 1947
To Purchase Foreign Exchange for Payment of Imports
to
TF133230000201
1540 0201 13
Date:
- Contd Page/2 -
[Original copy for Bangladesh Bank and
duplicate for AD's matching with EC. Copy of
Bill of Entry/Customs certified invoice]
( THIRTY SEVEN THOUSAND TWENTY SIX )
LC NO: 154013010272
31-DEC-13
1. I /We declare:
(a) That the above payment is due and that I/we have not already obtained exchange for payment of (any of) these goods, nor have I/we made any other
application for that purpose.
(b) The amount of Foreign Exchange mentioned above represents the correct prevailing market price for these goods on the date of contract in country of Export.
(c) That I/we am/are neither connected with the exporters abroad directly or indirectly nor do I/we have any financial or other interest in the exporters abroad.
2. I/We certify that the above import is covered by a valid L.C. Authorisation Form.
3. I/We undertake to clear the goods for consumption in Bangladesh within four months of the date of this application and shall, before the expiry of that period,
surrender to the Bangladesh Bank through yourselves the AUTHENTICATED COPY/IES OF THE CUSTOMS' BILLS OF ENTRY FOR CONSUMPTION IN
BANGLADESH or certified invoice/s covering the above goods, along with the Duplicate copy of this form (See note (a) below).
4. I/We declare that the statements made in this application are true to the best of my/our knowledge and belief.
5. I/We assume full responsibility for complying with the provisions of the Foreign Exchange Regulation Act, 1947 and rules, orders and directions made or issued there under.
BANGLADESH BANK APPROVAL (if Required)
(Valid for 30 days from the date of approval)
Approval for : ______________________________________________________________________________________
(Amount in figures & words)
Approval No : ___________________________ date _________________________
Seal and Signature

DECEMBER
9
SINGAPORE
1206
SINGAPORE
1206
FLEXO
GRAVURE PRIN
32151910
KG
31
16000
16000
CHITTAGONG
CHITTAGONG
COMMERCIAL
COMMERCIAL
U.S.
DOLLAR
01
37060
37026
Month Country
Receiving
Payment
Country
Origin of Goods
Commodity
Unit Quantity
Quantity of goods Place of
importation
Amount
Coded by: ___________________
Checked by: ___________________
Date: ____
Signature and Stamp of the
Authorised Dealer
See Chapter 7 Para 28(a)
APP.5 11
Page - 2
NOTES FOR IMPORTERS: (PLEASE READ CAREFULLY)
(a) 'I.M.P' Forms are in sets of two forms in each. The importer should complete and sign both copies
of the Forms and hand them over to the Authorised Dealer (Bank) through whom the remittance is being
made without separating the indivisual copies.
(b) The Form should be completed in every required detail. There should be no alterations or deletions
in the wording of the Form except where provided. The Form should be signed by the Importer or his
Authorised Agents holding Power of Attorney from the original importer. Importers are advised that a
false statement on this Form constitutes an offence under Section 22 of the Foreign Exchange
Regulation Act, 1947. Omission of essential information constitutes a false declaration.
(c) The attention of Importers is drawn to sub-section 3 of the Section 4 of the Foreign Exchange
Regulation Act, 1947. Exchange sanctioned for a particular purpose must be utilised for that purpose
only and all conditions attaching to the sanction must be compiled with. If any of the prescribed
conditions can not be fulfilled and as a result the exchange can not be utilised in whole or in part
for the purpose for which it was sanctioned, the unutilised amount must immediately be refunded
through an Authorised Dealer in foreign exchange in Bangladesh.
Currency Type
Of
L.C.A.F
LC NO: 154013010272
31-DEC-13 ____