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#8. satvirTo-sabaJo deklaracia<br />

3<br />

deklaraciis dasabrunebeli egzemplari<br />

DECLARATIS RETURN SPECIMEN<br />

3<br />

31 satvirTo<br />

adgilebisa<br />

da saqonlis<br />

aRweriloba<br />

packeges and<br />

description of<br />

goods<br />

44. damatebiTi<br />

informacia/wardgen<br />

ili sabuTebi<br />

Add infos Doc<br />

Precented<br />

47. sabaJo<br />

gadasaxdeleb<br />

is gaangari-<br />

Seba<br />

Calculation of<br />

Taxes<br />

satvirTo-sabaJo deklaracia ssd1 Single Administrative Document SAD1 deklaraciis saxe Declaration<br />

2 gamgzavni/eqsportiori Exporter/Consigner #<br />

3 damat. furc 4<br />

Add. lists<br />

reg. # reg. TariRi: Reg Date:<br />

8 mimRebi/importiori Importer/Consignee #<br />

reg. # reg. TariRi: Reg Date:<br />

14 deklaranti/warmomadgeneli Broker/Declarant #<br />

reg. # reg. TariRi: Reg Date:<br />

18 satransporto saSualeba gamogzavnisas Transport on shiprnent 19 kontein.<br />

Ct<br />

5 sul saq. das<br />

Items<br />

adgilebis<br />

raod<br />

Tol Pack<br />

sacnobaro nomeri<br />

Customs Number<br />

9 finansur daregulirebaze pasuxismgebeli piri<br />

Resp.forfinancial regulation<br />

#<br />

10 daniS.1-li qvey<br />

1 ST Coant of dest<br />

15 gamomg. qvey.<br />

Country of export<br />

16. warmoS. qveyana<br />

Country of origin<br />

11 movaWre qvey.<br />

Trading country<br />

15. gamomg. qv.kodi<br />

C.E. code<br />

daniSnulebis qveyana<br />

Country of destination<br />

20 miwodebis pirobebi Terms of delivery<br />

21 satransporto saSualeba sazRvarze Local carrier (on border) 22 valuta da saq. saerTo<br />

faqtiuri Rirebuleba<br />

Total invoice value<br />

25 26 27<br />

29 sabaJo (saguSago) sazRvarze<br />

Chek point on border<br />

30 saqonlis Semowmebis adgili<br />

Location of goods<br />

markireba da raodenoba-konteinerebis nomrebi-saqonlis aRweriloba<br />

Marks and numbers-Conteiners No-Numbers and kind<br />

saxe<br />

Type<br />

daricxvis safuZveli<br />

Tax base<br />

ganakveTi<br />

Rate<br />

Jami<br />

Amount<br />

23 valutis<br />

kursi<br />

exch. rate<br />

28 finansuri an/da sabanko monacemebi<br />

Financial and/or banking data Bank code:<br />

a. f.<br />

M. P.<br />

32 saqon. #<br />

item<br />

34 warmoS.<br />

qveynis kodi<br />

37 sab.reJimi<br />

Procedure<br />

#<br />

12 13<br />

17.daniS. qv. kodi<br />

C.D. code<br />

24 garigebis<br />

xas. Nature of<br />

Transaction<br />

33 saqonlis kodi H.S.C. code<br />

35 bruto wona<br />

item Gross wt (kg)<br />

38 neto wona (kg)<br />

item net wt (kg)<br />

40 saerTo deklaracia/winmswrebi sabuTi<br />

General decl/Previous Documents<br />

41 damat.zomis erT<br />

Supol unit<br />

48. winaswari gadaxdis<br />

angariSi #<br />

Prepaid Acc. number<br />

vrceli gaangariSeba<br />

36 preferenciebi<br />

Pref<br />

39 kvota<br />

Quote<br />

42 saq.faqt. Rir-ba<br />

Invoice value (N.C.)<br />

45 sabaJo Rirebuleba<br />

Customs Value (N.C.)<br />

43<br />

46 statistikuri<br />

Rirebuleba Statistical Value<br />

49. sawyobis dasaxeleba<br />

Identification of warehouse<br />

Accounting details<br />

deklaraciaSi moyvanili informaciis siswores vadastureb Information given in declaration is valid xelmowera Signature<br />

51. tranzitis<br />

qveynebi<br />

da sabaJoebi<br />

Customs of<br />

transit<br />

countries<br />

52. 53. sabaJo da daniSnulebis qveyana<br />

Customs and country of destination<br />

sabaJo kontroli Customs control 54. adgili da TariRi Plase and date<br />

89

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