快件內件總價值/Total Value of the Goods
in the Shipment(美元/USD)
制造商或出口商名稱及地址/
Name and Address of Manufacture/Importer
出口原因/Reason for Export
寄件人情況 / SHIPPING DETAILS
我證明并保證本文件中所填寫的各項內容與向海關部門申報的情況及快件內裝物品的實際情況符合/I certify and pledge
that all information filled in this document is conformed to the details declared to the Customs and
conformed to the actual conditions of the goods in the shipment.