Form C4
IMPORT ENTRY
Client Reference
Entry Type
Entry Number
Payment Method
Importer
Code
Agent
Code
Customs Controlled Area
Code
Declarants Code
Invoice Number(s)
Invoice Terms
I .................................................................................................................. Importer/Agent of Importer
declare that the particulars contained in this entry are true and correct
....................................................................................................
.........................................
Signature
Date
COMPLETION OF SIGHT/TEMPORARY ENTRY
PERMIT INFORMATION
OTHER INFORMATION
Original Entry Number
Authority
Number
Code
Data
Remarks
SHIPPING DETAILS
Mode of Transport
Voyage No.
Craft/Flight
Date of Import
Total Gross Weight (kg)
Sea / Air / Mail
Port of Loading
Port of Discharge
Delivery Authority
Code
CONTAINER AND PACKAGE INFORMATION
Number & Type of Packages
Container Number
Container Status Bill Number
Bill Type
DETAIL LINE INFORMATION
Detail Line No.
Description of Goods
Tariff Item
Concession Code
1
Relationship Indicator
Preference Indicator
YES / NO
Q / N
Country of Export
Country of Origin
Supplier Code
Supplier Name
Statistical Unit
Statistical Quantity
Supplementary Unit
Supplementary Quantity
VFD (Foreign)
Currency Code
VFD (Whole NZ$)
Exchange Rate
Insurance (Whole NZ$)
Freight (Whole NZ$)
Misc. Reason Code
Misc. Amount NZ$
Duty Payable NZ$
GST Payable NZ$
Total Payable NZ$ *
PERMIT INFORMATION
PROHIBITED GOODS
OTHER INFORMATION
Authority
Number
Code
Code
Data
ENTRY TOTAL
Total Payable NZ$
* An Import Entry Transaction Fee is payable in addition to this Total Payable.