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Singapore Customs,

55 Newton Road #07-01,

Revenue House

Singapore 307987
Tel No. : 6355 2000
Fax No. : 6355 2134
Email:
Form reference: SC-A-004 (Ver 01 – 04/16)

AGENT’S APPLICATION FOR PRODUCT CODE

This form may take you 5-10 minutes to fill in.
You will need the following information to fill in the form:
(a)Trade Documents (e.g. Factory’s export price list or confirmation of the new prices )
(b)Letter from supplier explaining price change
(c)Vehicle’s specifications – Technical specifications
(d)Vehicle’s specifications – Standard and optional accessories list
(e)Vehicles Brochure
SECTION A IMPORTER’S DETAILS
(1)Name of Importer: / (2)Importer’s UEN:
(3)Address: / (4)Supplier’s Code:
(5)Tel No.: / (6)Fax No.: / (7)E-mail:
SECTION B DESCRIPTION OF THE MODEL
(8)Make / Model: * New / Existing Model (* Delete as appropriate)
(9)Engine Capacity: / (10) Date of Manufacture:
(11)Place of Manufacture/Country of Origin: / (12) Model Code:
(13)Engine Power (HP): / (14) Transmission type:
(15)Invoice Price: / (16)Incoterms: * EXW / FOB / CFR / CIF
SECTION C REASON FOR PRODUCT CODE APPLICATION(TICK WHERE APPLICABLE, YOU MAY TICK MORE THAN ONE)
(17)Reason for Product Code Application:
(i)New Model
(ii)New Variant
(iii)Face Lift
(iv)New Model Year
(v)Change in Freight and Insurance
(vi)Change in Exchange Rate
(vii)Upgrade of specifications and/or standard options
(viii)Others (please specify):
SECTION D SUPPORTING DOCUMENTS CHECKLIST
(18)Factory’s export price list or confirmation of the new prices / Compulsory
(19)Letter from supplier explaining price change / Compulsory
(20) Vehicle’s Specifications – Technical specifications / Compulsory
(21) Vehicle’s Specifications – Standard and optional accessories list / Compulsory
(22) Vehicles Brochure / Optional
(23)Others, please specify: / Optional
SECTION E COMPARISON MODEL DETAILS
(24)Make / Model of Comparison Model: / (25)Product Code of Comparison Model:
(26)Unit Price and Currency of Comparison Model:
Differences between new import and comparison model:
New Import / Comparison Model
(27) Engine
(28) Exterior
(29) Interior
(30) Chassis
(31) Equipment
(32) Others
SECTION F DECLARATION
I hereby certify that all the above particulars declared by me are true and correct and that the price is the sole consideration. No part of the proceeds of such subsequent resale, use or disposal of the motor vehicle will accrue directly or indirectly to the supplier.To support my application, the following documents in Section D are attached.
(33)Name: / (34)Signature & Date:
(35)Designation: / (36)* NRIC / Passport No. :
SECTION G FOR OFFICAL USE ONLY
(37)Product Code: / (38) Customs Value: Per Unit

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