| 预录入编号(Pre entry number): |  | 
	                        
	                          | 海关编号(Customs Recmord Number ): |  | 
	                        
	                          | 收发货人(shipper): | * | 
	                        
	                          | 出口口岸(port of export): | * | 
	                        
	                          | 出口日期(Export date): |  | 
							
								| 申报日期(Date of declaration): |  | 
	                        
	                          | 生产销售单位(Production and marketing unit): | * | 
	                        
	                          | 运输方式(Mode of Transport): |  | 
	                        
	                          | 运输工具名称(Conveyance): |  | 
	                        
	                          | 提运单号(Bill of lading number): |  | 
	                        
	                          | 申报单位(Declaration unit): |  | 
	                        
	                          | 贸易方式(type of trading): | * | 
	                        
	                          | 征免性质(Kind of tax): |  | 
	                        
	                          | 备案号(Customs registration number): |  | 
	                        
	                          | 贸易国(地区)(Trading Country): | * | 
	                        
	                          | 运抵国(地区)(Destionation Country): | * | 
	                        
	                          | 指运港:仁川(port of destination P.O.D.  Incheon): | * | 
	                        
	                          | 境内货源地(Place of Manufacture): |  | 
	                        
	                          | 许可证号(License Number): |  | 
	                        
	                          | 成交方式(Terms of Trade): | * | 
	                        
	                          | 运费(FREIGHT): |  | 
	                        
	                          | 保费(Insurance premium): |  | 
	                        
	                          | 合同协议号(Contract Number): | * | 
	                        
	                          | 件数(Numbers of Packages): | * | 
	                        
	                          | 包装种类(Kinds of Packing): | * | 
	                        
	                          | 毛重(千克)(Gross Weight(kilo)): | * | 
	                        
	                          | 净重(千克)(Net Weight(kilo)): | * | 
	                        
	                          | 集装箱号(Container Number): |  | 
	                        
	                          | 随附单证(Attached Documents): |  | 
	                        
	                          | 标记唛码及备注(Shipping Marks & Remarks Declarant): |  | 
	                        
	                          | 项号(Item Number): |  | 
	                        
	                          | 商品编号(H.S Code): | * | 
	                        
	                          | 商品名称(Description of Goods) : | * | 
	                        
	                          | 规格型号(ncluding Specification&Type   specifications and models): | * | 
	                        
	                          | 数量及单位(Quantity&Unit Uinal): | * | 
	                        
	                          | 最终目的国(地区)(Destination): |  | 
	                        
	                          | 原产国(地区)(Country of origin): |  | 
	                        
	                          | 单价(Unit Price): | * | 
	                        
	                          | 总价(Total Amount): | * | 
	                        
	                          | 币制(Currency): | * | 
	                        
	                          | 征免(Exemption): |  | 
	                        
	                          | 特殊关系确认(Special relationship validation): |  | 
	                        
	                          | 价格影响确认(Price impact confirmation) : |  | 
	                        
	                          | 支持特许权使用费确认(Support concession fee recognition) : |  | 
	                        
	                          | 录入员(Entry Clerk) : |  | 
	                        
	                          | 录入单位(Entry unit) : |  | 
	                        
	                        	| 兹声明以上内容承担如实申报、依法纳税之法律责任 (It is hereby declared that the above contents shall bear the legal responsibility for paying tax in accordance with the law )
 | 
	                        
	                          | 报关人员(Customs broker): |  | 
	                        
	                          | 申报单位(签章)(Declaration unit(signature)): |  | 
	                        
	                          | 海关批注及签章(Customs endorsement ( signature)): |  | 
                          	
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