| | | А.Т.А. CARNET | | | | | | | | | | | | | | CARNET A.T.A. | |
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I M P O R T A T I O N
| I M P O R T A T I O N
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| A. | HOLDER AND ADDRESS / Titulaire et adresse | | FOR ISSUING ASSOCIATION USE / | |
| | | | Reserve a l'association emettrice | |
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| | | G. | IMPORTATION VOUCHER N | | |
| | | | Volet d'importation n | | | | | |
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| | | a) | CARNET No. | | | | | |
| | | | | | | | | | | | | Carnet N | | | | | |
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| B. | REpreSENTED BY <*> / Represente par <*> | b) | ISSUED BY / Delivre par | | | | | |
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| C. | INTENDED USE OF GOODS / Utilisation prevue des | c) | VALID UNTIL / Valable jusqu'au | | | | | |
| | marchandises | | | | | | | | | | | | |
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| | | | year | | month | | day (inclusive) | | | | | |
| | | | annee | | mois | | jour (inclus) | | | | | |
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| | | D. | MEANS OF trANSPORT <*> / Moyens de transport <*> | | FOR CUSTOMS USE ONLY / Reserve a la douane | |
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| | | | | H. | CLEARANCE ON IMPORTATION / | |
| | | | | | Dedouanement a l'importation | |
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| | | | | a) | The goods referred to in the above declaration have been temporarily imported / | |
| | | | | | Les marchandises faisant t'objet de la declaration ci-contre ont ete importees temporairement. | |
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| | | E. | PACKAGING DETAILS (Number, Kind, Marks, etc.) <*> / | b) | Final date for re-exportation / production to Customs <*> / | |
| | | | Detail d'emballage (nombre, nature, marques, etc.) <*> | | Date limite pour la reexportation / la representation a la douane <*>: | |
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| | | | | | year | | month | | day (inclusive) | | | | | |
| | | | | | annee | | mois | | jour (inclus) | | | | | |
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| | | F. | TEMPORARY IMPORTATION DECLARATION / | c) | Registered under reference N <*> / Enregistre sous le n <*> | |
| | | | Declaration d'importation temporaire | | | |
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| | | | | d) | Other remarks: <*>; / Autres mentions: <*>; | | | |
| | | | I, duly authorised: / Je soussigne, dument autorise: | | | | | | | | | | | | |
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| | | | a) | declare that I am temporarily importing in compliance | | | | | | | | | | | | |
| | | | | with the conditions laid down in the laws and | | | | | | | | | | | | |
| | | | | regulations of the country / Customs territory of | | | | | | | | | | | | |
| | | | | importation, the goods enumerated in the list overleaf | | | At / A | | |
| | | | | and described in the General List under item No.(s) / | | | | Customs Office / Bureau de douane | |
| | | | | declare importer temporairement, dans les conditions | | | | | | | | | | | | |
| | | | | prevues par les lois et reglements du pays / | | | | | | | | | | | |
| | | | | territoire douanier d'importation, les marchandises | | | | | | | | | | | |
| | | | | enumerees a la liste figurant au verso et reprises a | | | | | | | | | | | |
| | | | | la liste generale sous le(s) N(s). | | | | | | | | | | |
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| | | | b) | declare that the said goods are intended for | | | / | / | | | | | |
| | | | | use at / declare que les marchandises sont | | | Date (year / month / day) | | Signature and Stamp | | |
| | | | | destinees a etre utilisees a | | | Date (annee / mois / jour) | | Signature et Timbre | | |
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| | | | c) | undertake to comply with these and | | | | | | | | | | | | |
| | | | | laws regulations and to re-export the | | | Place | | | Date (year / month / day) | / | / | | |
| | | | | said goods within the period stipulated | | | Lieu | | | Date (annee / mois / jour) | | | | |
| | | | | by the Customs Office or regularize their | | | | | | | | | | | | |
| | | | | status in accordance with the laws and | | | | | | | | | | | | |
| | | | | regulations of the country / Customs | | | | | | | | | | | | |
| | | | | territory of importation. / | | | | | | | | | | | | |
| | | | | m'engage a observer ces lois et reglements et | | | Name | | |
| | | | | a re-exporter ces marchandises dans les delais | | | Nom | | |
| | | | | fixes par le bureau de douane ou a regulariser | | | | | | | | | | | | |
| | | | | leur situation selon les lois et reglements du pays / | | | | | | | | | | | | |
| | | | | territoire douanier d'importation. | | | | | | | | | | | | |
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| | | | d) | confirm that the information given is true | | | | | | | | | | | | |
| | | | | and complete. / certifie sinceres et completes les | | | | | | | | | | | | |
| | | | | indications portees sur le present volet. | | | | | | | | | | | | |
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| | | | | | | | | | | | | | | | Signature | | Signature | | |
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