URA/ASYCUDAWorld A OFFICE OF DISPATCH/EXPORT

1 DECLARATION RADDEx No.

UGKLA
2 Exporter 1017907420 No. EX 8 KAMPALA
AIVA INTERNATIONAL LIMITED Customs Reference
KAMPALA KAMPALA CENTRAL DIVI KAMPALA CENTRAL 3 Forms 4 Load E 6127 05/02/2025
DIVISION
1 1 Manifest
KOLOLO IVLUGOGO NAKAWA
5 Items 6 Nbr packages 7 Reference number
CORONATION UMA SHOW GROUND LUGOGO
669 100921 KAMPALA 1 450 2025 S46233/S127923

8 Consignee No. 9 Financial No.

MAPENDO KADENGE KAHESI

DR.CONGO

10 Cty f. dest 11 Trading 13 C.A.P.

of CD cty.

14 Declarant No. 1016533672 15 Country of export 15 C.E. 17 C.D. Code

NLLE GREAT INBOUND AGENCIES LIMITED Uganda a UG b a CD b

24B,, 16 Country of origin 17 Country of destination
LUTHULI AVENUE,BUGOLOBI
India Democratic Republic of
18 Identity and nationality of means of transport at arrival / at 19 20 Delivery terms

CGO 7410AG19 CD no FOB

21 Identity and nationality of active means of transport crossing the 22 Currency & total amount 23 Exch. rate 24 Nature of

CGO 7410AG19 CD USE 6,300.000 3,666.64 8 5 transac.

25 Mode 26 Inland mode 27 Place of loading/unloading 28 Financial and banking data Bank DTB
3 at border 3 Transport Terms of T01 CASH
29 Office of entry/exit 30 Location of goods DIAMOND TRUST BANK (U) LTD
UGMP MPONDWE W0078
31 Packages Marks and numbers - Containers No(s) - Number and kind 32 Item 33 Commodity code
and
Marks & no AS ADD 1 No 48189000 000
descriptio
of goods 34 Cty. orig. 35 Gross mass (kg) 36 Prefer.
of

Number and 450 NE a IN b 2,025.0000

Kind Unpacked or unpackaged 37 PROCEDURE 38 Net mass (kg) 39 Quota

Containers No
8470 000 1,710.0000
40 Summary declaration / Previous document S/L
Other toilet paper and similar paper of a kind used for household or UGKLA 2024 S 127923 art. 1
41 Supplementary units 43 V.M.

44 Add. info Licence No D.Val D.Qty KGM 1,710.0000 6,300 cod

Document
Produced
0-0 A.I. Code 45 Adjustment

Certificate A.D.
and autho- 46 Statistical value
rization
23,099,832
47 Calcul- Type Tax base Rate Amount M 48 Deferred payment 49 Identification of warehouse
ation of
taxes 102 23,099,832 35.00 8,084,942 0 UG001
105 23,099,832 6.00 1,385,990 0 B ACCOUNTING DETAILS
401 31,184,773 18.00 5,613,260 0 CASH
Mode of payment
151 1 1.00 0 1
Assessment number A 34231 / Date 05/02/2025
Receipt number Date

Guarantee 15,084,192 UGS Date

Total fees 0 UGS

Total 0 1 Total 0 UGS
50 Principal No. Signatur C OFFICE OF DEPARTURE

51 Intended Represented by
offices of Place and date
transit
Location of Destination
country
UGMPO Mpondwe Yard
52 Code 53 Office of destination and country
not valid
UGMPO MPONDWE
D CONTROL BY OFFICE OF DESTINATION Stamp: 54 Place and date

Declarant name/representative
Signatur Catherine Burungi