.RARR LOGISTICS — CUSTOMS DECLARATION (TEMPLATE)
================================================

Declaration no: ______________   Date: ______________

Exporter / Shipper:
________________________________________________

Importer / Consignee:
________________________________________________

Country of export: ______________   Country of import: ______________
Mode of transport: ______________   Port of entry: ______________

---------------------------------------------------------------
 HS code | Description | Qty | Value (currency) | Country of origin
---------------------------------------------------------------
         |             |     |                  |
         |             |     |                  |
         |             |     |                  |
---------------------------------------------------------------

Total declared value: ______________
Purpose of shipment:  [ ] Sale  [ ] Gift  [ ] Sample  [ ] Return
                      [ ] Personal effects  [ ] Other: __________

I declare that the particulars given in this declaration are
correct and that this shipment contains no prohibited or
restricted items.

Name: ______________   Signature: ______________   Date: __________