Tax Levy and Exemption Certificate for Goods

Application Unit:

Item Name:

Certificate Issuing Date:

                             Date:

Validity period:

To the date of

Port of destination:

Contract No.:

No.

Name of goods

Specification

Quantity

Unit

Amount

Currency system

Approval opinions of competent customs on tax levy and exemption

1

2

3

4

Remark

Matters of attention:
1. This form is valid only for once. If the goods under a same contract are imported from more than one port, the form shall be filled out separately for each port. If the goods under a same contract arrives by installments, declaration shall be made to the approving customs, and this form is filled out separately for each installment.

2. The column of Item Name in this form shall be filled out as tax-reduced and exempted items, such as technological renovation and loan from World Bank.

3. This form is submitted to the customs for examination during import of goods, and copy of this form is invalid.

4. This form is valid within half a year upon the date of issuing. Any date beyond the validity period requires application for extension or return to the original approving customs. 

5. For goods approved for import, such as proposed use for other purpose, transfer or sales, the original application unit for tax exemption shall submit to the original approving customs for approval in advance, and make up the tax by law; or otherwise, the customs shall handle the situation by law.

Seal of approving customs

Responsible person

　Date

Remarks of clearance customs



Responsible person

Date