Tag

Name

St

Format

St

Usage / Remarks

NAD

3035

Party function code qualifier

M

an..3

M

AE

Declarant's agent/representative

C082

Party identification details

C

N

3039

Party identifier

M

an..35

N

Not used

1131

Code list identification code

C

an..17

N

Not used

3055

Code list responsible agency code

C

an..3

N

Not used

C058

Name and address

C

C

3124

Name and address description

M

an..35

M

Agent / Exporter Declaration - Name and Surname

Agent / Exporter Declaration - Name and Surname <== Mandatory if Agent / Exporter Declaration provided

3124

Name and address description

C

an..35

C

Agent / Exporter Declaration - Name of the Company

Agent / Exporter Declaration - Name of the Company <== Mandatory if Agent / Exporter Declaration provided

3124

Name and address description

C

an..35

C

I hereby declare that the above is a true description and complete return of the goods in the above
mentioned package and that the goods are in the same condition in which they were imported. In terms of
Item 522.03 of Schedule No. 5 to the Customs and Excise Act, I hereby apply for a refund of the duty
originally paid on the goods as indicated above.

Y

Yes

N

No

Agent / Exporter Declaration - Declaration Check Box

3124

Name and address description

C

an..35

N

Not used

3124

Name and address description

C

an..35

N

Not used

C080

Party name

C

N

3036

Party name

M

an..70

N

Not used

3036

Party name

C

an..70

N

Not used

3036

Party name

C

an..70

N

Not used

3036

Party name

C

an..70

N

Not used

3036

Party name

C

an..70

N

Not used

3045

Party name format code

C

an..3

N

Not used

C059

Street

C

N

3042

Street and number or post office box identifier

M

an..256

N

Not used

3042

Street and number or post office box identifier

C

an..256

N

Not used

3042

Street and number or post office box identifier

C

an..256

N

Not used

3042

Street and number or post office box identifier

C

an..256

N

Not used

3164

City name

C

an..35

N

Not used

C819

Country subdivision details

C

N

3229

Country subdivision identifier

C

an..9

N

Not used

1131

Code list identification code

C

an..17

N

Not used

3055

Code list responsible agency code

C

an..3

N

Not used

3228

Country subdivision name

C

an..70

N

Not used

3251

Postal identification code

C

an..17

N

Not used

3207

Country identifier

C

an..3

N

Not used