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Customs Clearance Payment Receipt

This document appears to be a customs declaration form containing information about an import or export shipment. It includes details like the customs certification, means of transportation, dollar value, importer/exporter information, insurance costs, customs clearance code, marks and numbers, dates, rates, taxes, supplier/buyer data, invoice information, container numbers, and a list of items being imported/exported along with their descriptions and values. The document is signed by a customs broker certifying the accuracy of the information provided.

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0% found this document useful (0 votes)
19 views3 pages

Customs Clearance Payment Receipt

This document appears to be a customs declaration form containing information about an import or export shipment. It includes details like the customs certification, means of transportation, dollar value, importer/exporter information, insurance costs, customs clearance code, marks and numbers, dates, rates, taxes, supplier/buyer data, invoice information, container numbers, and a list of items being imported/exported along with their descriptions and values. The document is signed by a customs broker certifying the accuracy of the information provided.

Translated by

ScribdTranslations
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PEDIMENT Page 1 of N

NUM. PEDIMENT: T. OPER: CVE. PEDIMENT: REGIME: CERTIFICATIONS


DESTINATION: TYPE CHANGE: GROSS WEIGHT: CUSTOMS E/S:
MEANS OF TRANSPORTATION DOLLAR VALUE:
INPUT/OUTPUT: ARRIBO: OUTPUT: CUSTOMS VALUE:
PRICE PAID:
IMPORTER/EXPORTER DATA
RFC: NAME, DENOMINATION OR CORPORATE NAME:
CURP:
ADDRESS:

[Link] INSURANC FLETES PACKAGING OTHER INCREMENTAL


0 E 0 0 0
0
ELECTRONIC ACKNOWLEDGEMENT CUSTOMS CLEARANCE
OF VALIDATION: SECTION CODE:
C23CBKZ

MARKS, NUMBERS AND TOTAL NUMBER OF PACKAGES:


DATES RATES AT THE PEDIMENTO LEVEL
PRESENTATION: CONTRIB. CVE. T. RATE RATE
PAYMENT: DTA
PREV
LIQUIDATION TABLE
CONCEPT F.P. AMOUNT CONCEPT F.P. AMOUNT TOTALS
PREV 0 IGI 0 CASH
VAT 0 DTA 0 OTHER
TOTAL
SUPPLIER OR BUYER DATA
ID. FISCAL NAME, COMPANY NAME OR CORPORATE ADDRESS: BAILEN N. 84 CP 08009 BONDING
NAME

NUM. INVOICE DATE INCOTERM CURRENCY [Link] FACTOR [Link] [Link]


FACT

NUMBER (WAYBILL/ORDER)/ID:
NUMBER / TYPE OF CONTAINER:
KEY / COMPL. IDENTIFIER

REMARKS

CUSTOMS BROKER, CUSTOMS BROKER OR WAREHOUSE AGENT I DECLARE UNDER OATH, IN ACCORDANCE WITH
NAME OR REZ. SOC: THE PROVISIONS OF ARTICLE 81 OF THE CUSTOMS
LAW: PATENT OR AUTHORIZATION:

AUTOGRAPHED SIGNATURE
ANNEX TO THE REQUEST Page2 of 2
NUM. PEDIMENTO: TYPE OF OPER. CVE. PEDIM: RFC:
CURP:
ITEMS
FRACTION SUBD. VINC. ME UMC CANT UMT AMOUNT P. P.
T UMC UMT V/C O/D
VAL

SEC DESCRIPTION (VARIABLE LINES AS REQUIRED) CON. RATE T.T. F.P. AMOUNT

VAL IMP. PRICE PRICE VAL. AGREG. GSE


ADU/USD PAGE. UNIT. VAT

BRAND MODEL PRODUCT CODE


IGI
001
IGI
IGI
VAT
PERMISSI PERMIT NUMBER SIGNATURE VAL. COM. QUANTITY UMT/C
ON DISCLAIMER DLS. 0.000
NM 0.00
IDENTIF. SUPPLEMENT IDENTIF. SUPPLEMENT
UM O EN N

002

PERMISSI PERMIT NUMBER SIGNATURE VAL. COM. QUANTITY UMT/C


ON DISCLAIMER DLS. 0.000
NM 0.00
IDENTIF. SUPPLEMENT IDENTIF. SUPPLEMENT

003

PERMISSI PERMIT NUMBER SIGNATURE VAL. COM. QUANTITY UMT/C


ON DISCLAIMER DLS.
NM
IDENTIF. SUPPLEMENT IDENTIF. SUPPLEMENT

CUSTOMS BROKER, CUSTOMS BROKER OR WAREHOUSE I DECLARE UNDER OATH, IN ACCORDANCE WITH THE PROVISIONS
AGENT OF ARTICLE 81 OF THE CUSTOMS LAW: PATENT OR
NAME OR REZ. SOC: AUTHORIZATION:

RFC: CURP:
AUTOGRAPHED SIGNATURE

*********FIN DE PEDIMENTO ******NUM. TOTAL LINE ITEMS: 1******PREVALIDATOR KEY: 068*******

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