EXPORT DECLARATION SUPPLEMENTARY PAGE

Approved Form for Customs Act Sections 114(3)(c) & 162AA(3)(a) - Export Declaration - B957a

Complete one of these pages for each commodity

Page 2 of 7 Pages
Page numbering including initial B957 – in this instance am taking 4 pistols and 3 different types of ammo
1. Line No.
Leave blank / 3. Commodity Classification
Code (AHECC) Leave blank
2. Your Reference Norfolk Int pistol shoot 2011
3. Goods Description Hammerli SP20 #191475 .22lr Semi-auto pistol
Manufacturer, model, serial number, calibre, type of action (or Make, calibre & amount of ammo, including air pellets)
With 2 x 6 shot capacity magazines, 4 Allen keys, spare firing pin, and screw driver
Include all accessories & specify magazine/cylinder capacity
5. Goods Origin Code AU-QL
Australia - Queensland / 6. Temporary Import No.
Leave blank
7. Goods Origin Country Code
Leave blank
8. Net Quantity / a.) Amount
One / b.) Unit
No.
9. Gross Weight / a.) Amount
2.6 / b.) Unit
KG
10. Line FOB Value: $2500
Value of pistol and accessories (do similar for ammo)
11. Permit Details:
Leave blank
12. Assay Details:
a.) Assay Element / b.) Assay Concentration / c.) Assay Unit
Leave blank / Leave blank / Leave blank
Signature:
X / Date: