SINGLE ADMINISTRATIVE DOCUMENT

1 DECLARATION Office Code: P02A

2 Exporter /Supplier Address Port of Manila
4 4 Manifest No: WHL0020-19
EVEREST CHEMICALS LTD
XINGMIN ROAD TIAN HE DISTRIC GUANGDONG, CHINA 3 Page
Customs reference no.: C-43075
1 1 Date : 04/01/2019 18:36:46
5 Items 6 Tot Pack 7 Reference Number

1 3,850 5Z3A1900073
8 Importer/Consignee, Address Tin: 001095517000 9 CRF No.
ILYON INDUSTRIAL CORPORATION
16A BOWLING ST. SAINT FRANCIS VILLA
GE CAINTA
RIZAL 1212
10 11 12 Tot. F/I/O 13 T. Rel.
1212
PHILIPPINES XX XX 2,121.00
14 Broker/Attorney-In-Fact, Address Tin: 228123632000 15 Country of Export 15 C.E. Code 17
RONALD R. BELENO
11 dove st. area 1 veterans CHINA CN
bagong silangan 16 Country of Origin 17
quezon city PHILIPPINES
CHINA
18 Vessel/Aircraft Registry No. 19 Ct 20 Terms Of Delivery
TENG YUN HE WHL0020-19 0 CIF
21 Local Carrier (If Any) : 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank

USD 15,400.00 52.782 2

25 26 27 Transhipment Port 28 Financial and Banking Data Bank Code : 998
04/02/2019 XX Terms of Payment : 01-Basic
1
29 Port Of Destination 30 Location Of Goods Bank Name : PCHC
P02A-Port of Manila S01 Branch : NA Bank Ref No. : 010533457-0007672
Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Marks & Nos : N/M
1 28362000000 0.00
No. Of Packages : 3,850
31 Packages 34 C.O. Code 35 Item Gross Wgt. 36 Pref
and Desc.
Of Goods
Number and Kind : BG-BAG
CN 154,577.50 Kg(s) ACFTA
Containers No(s) : 37 Procedure Item Net Weight 39 Quota
OOLU1248494, OOLU1427036, OOLU1454330, OOLU2855173,
OOLU1501956 000 154,000.00 Kg(s) NNNNN
- Disodium carbonate 4000
40a AWB/BL 40b Previous Doc No.
SODA ASH LIGHT
OOLU2027602140
OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value (F.C.) 43 V.M.
44 Add Infos
Doc / Produ.
1 0.000 0.00
Certif. & Aut.
0.00 15,400.00 1
79,437 + 32,514 + 0 + 3,635 - 30,149
45 Adjustment

Prev Doc Reference : 1.00

46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
EC190243 924,793.42
48 Prepaid Account No. 49 Identification of Warehouse
47 Calcula- Type Tax Base Rate Amount MP
tion of Taxes

CUD 924,793.42 0% 0.00 1 47b ACCOUNTING DETAILS

.............................................................................................................................
VAT 966,063.86 12% 116,120.00 1 Mode Of Payment
:
CASH
Assessment Number : - Date :
Receipt Number : - Date :
Guarantee : Date :
.............................................................................................................................
Total Fees 3,127.00
Total
116,120.00 Total Assessment 119,247.00
50 We hereby certify that the information contained in all pages of this Declaration and the documents submitted are Subscribed and sworn to before me
to the best of out knowledge and belief true and correct.

RONALD R. BELENO ILYON INDUSTRIAL CORPORATION Administering Officer /

Notary Public
Broker Date : Importer/Attorney-In-Fact

51 AUTHORIZATION 52 Control at Office Destination

Date Print name Position Date Print name Position

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 53 INTERNAL REVENUE (TAX PER BOX #46 & 47)

TAXABLE VALUE PHP 924,793.42 WHARFAGE 3,635.00 OTHERS 1,000.00

BANK CHARGES 0.00
ARRASTRE CHARGES 30,149.00 TOTAL LANDED COST PHP 966,063.41
CUSTOMS DUTY 0.00
6,205.99 DOCUMENTARY STAMP 280.00 TOTAL VAT PHP 116,120.00
BROKERAGE FEE

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION 55 NO. OF PACKAGES EXAMINED EXAMINATION RETURN 56 DATE RECEIVED 57 DATE RELEASED

ITEM
NO DESCRIPTION IN TARIFF TERMS SHOULD BE QTY UNIT UNIT VALUE TARIFF HEADING RATE

PLEASE REFER TO RIDER/S FOR FINDINGS ON ITHER ITEMS

REVISED CHARGES LIQUIDATION

59 CHARGES 60 DECLARATION 61 FINDINGS 62 DIFFERENCES 65 LIQUIDATION AMOUNT

PHP
DUTY

BIR Taxes
66 SHORT/EXCESS
VAT PHP
Excise Tax/Ad
Valorem 67 REMARKS

Others

Surcharges

TOTAL

63 ACTION DIRECTED / 64 68
RECOMMENDED
Date Date

69
Date Date

CONTINUATION FROM BOX # 31 FREE DISPOSAL

CUD 0.00
VAT 116,120.00

Total Item Taxes 116,120.00

IPF 1,000.00
CDS 250.00
IRS 30.00
CSF 1,847.00

Total Global Taxes 3,127.00

OOLU0531690, OOLU1264900
119,247.00

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS

Terms Of Payment

Code Account

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 Bank Reference Number : 010533457-0007672 Selectivity Color : RED Section : 11
Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS
TEMPORARY ASSESSMENT NOTICE

Customs Office P02A Port of Manila

Identification of the Declaration

Ref Registration Assessment Nbr of

Year Number Date Year Number Day/Mth Items
Model

4 4 2019 C-43075 04/01/19 2019 - 1

Declarant Reference No : 5Z3A1900073

Declarant : 228123632000 RONALD R. BELENO
11 dove st. area 1 veterans
bagong silangan
quezon city PHILIPPINES

Importer : 001095517000 ILYON INDUSTRIAL CORPORATION

16A BOWLING ST. SAINT FRANCIS VILLA
GE CAINTA
RIZAL 1212
1212
PHILIPPINES
Mode of Payment : CASH Account Number

Receipt number and - Statement number and date

date :

CUD 0.00
VAT 116,120.00

Total Item Taxes 116,120.00

IPF 1,000.00
CDS 250.00
IRS 30.00
CSF 1,847.00

Total Global Taxes 3,127.00

Total assessed amount for the declaration

Amount currently to be paid 119,247.00

This temporary Assessment Notice provides advice to the declarant of the entry number assigned to the declaration
encoded. This document is of a temporary nature. The final Assessment Notice will be issued by BOC staff.

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 TRANSACTION RECEIPT

TRANSACTION RECEIPT NO. 5Z3A1900073

ILYON INDUSTRIAL CORPORATION

CLIENT 16A BOWLING ST. SAINT FRANCIS VILLA
GE CAINTA
RIZAL 1212
1212
PHILIPPINES
TIN 001095517000

TRANSACTION DETAILS

ENTRY DATE 04/01/2019 00.00.00

ENTRY NO. C-43075

HOUSE NO. OOLU2027602140

MANIFEST NO. WHL0020-19

REFERENCE NO. 5Z3A1900073

AMOUNT 45.00

TOTAL AMOUNT DUE FORTY FIVE PESOS ONLY

Certified correct :

CARGO DATA EXCHANGE CENTER, INC.