FORM N

S.Q. Satwick

Kailas P.Works                                                                                                 Bombay_______________________19


                                                To,
                                                The Dy. ASSESSOR & COLLECTOR (OCTROI)
Sir,  
       I have request that undermentioned Articles which have been imported by me per __________________________________________________ for the purpose of immediate exportation form (__________of export) _________________________________________ per ____________________________ and to be consigned to (name of the consignee) ___________________________________ at (destination) ___________________________ be exempted from levy of Octroi. Import - Export

Free of Octroi

No____________

Date__________

Initials of Registering Officer

 

No. and

date of

Import

Document

No.of Packages

Description of packages

Description of articles

Import Marks if any

Weight or quatity as per import document

No. of packages escorted previously

No.of Packages on which Octroi has been paid

No.of Packages to be escorted

No. and date of export document

Wt. & value & rate for Octroi

Remarks

N Form

No.& date

No.of

Packages

No. of Packages

Import Bill No. & date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Let the above articles be removed free of Octroi to the Place of export under supervision of               I/We do hereby declare that

Shri______________________________________________________________________              the Application are truly stated.

                                           ( Name and Designation )

 Signature of the Supervising Inspector

 Date__________________________                                                                             __________________________________

                                                                                                              (Importer of his Agent or his duty constitu-

                                                                                                                   ted attorney)

(N.B. : Please turn over for the reverse side of the form)