Sultanate of Oman ‫ﺳﻠﻄﻨﺔ ﻋﻤﺎﻥ‬

Royal Oman Police ‫ﺷﺮﻃﺔ ﻋﻤﺎﻥ ﺍﻟﺴﻠﻄﺎﻧﻴﺔ‬

Directorate General of Customs ‫ﺍﻻﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺠﻤﺎﺭﻙ‬

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PORT ‫ﺍﻟﻤﻨﻔﺬ‬ DEC TYPE ‫ﻧﻮﻉ ﺍﻟﺒﻴﺎﻥ‬ DEC DATE ‫ﺗﺎﺭﻳﺦ ﺍﻟﺒﻴﺎﻥ‬ DEC NO. ‫ﺭﻗﻢ ﺍﻟﺒﻴﺎﻥ‬
Customs Declaration ‫ﺑﻴﺎﻥ ﺍﻟﺠﻤﺮﻛﻲ‬
Wajajah Land Border Export from Bonded Warehouse 31/08/2025 DECEBW31082511153679
NET WEIGHT ‫ﺍﻟﻮﺯﻥ ﺍﻟﺼﺎﻓﻲ‬ IMPORTER / EXPORTER ‫ﺍﻟﻤﺼﺪﺭ‬/‫ﺍﻟﻤﺴﺘﻮﺭﺩ‬ DELIVERY ORDER NO. ‫ﺭﻗﻢ ﺇﺫﻥ ﺍﻟﺘﺴﻠﻴﻢ‬
324.000 ‫ﻛﻴﺰﺍﻥ ﺵ ﻡ ﻡ‬ -- NIL --

GROSS WEIGHT ‫ﺍﻟﻮﺯﻥ ﺍﻟﻘﺎﺋﻢ‬ INTERCESSOR CO. ‫ﺍﻟﺸﺮﻛﺔ ﺍﻟﻮﺳﻴﻄﺔ‬ CAR / CAPT. / DRIVER ‫ﺍﻟﺴﺎﺋﻖ‬/‫ﺍﻟﻘﺒﻄﺎﻥ‬/‫ﺍﻟﻨﺎﻗﻠﺔ‬
765.000 ‫ﺃﺿﻮﺍﺀ ﺷﻨﺎﺹ ﺍﻟﺤﺪﻳﺜﺔ ﻟﻠﺘﺠﺎﺭﺓ‬ ‫ﺍﻟﺸﺮﻛﺔﺍﻟﻌﻤﺎﻧﻴﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﻠﻮﺟﺴﺘﻴﺔﺍﻟﻤﺘﻜﺎﻣﻠﺔ ﺵ ﻡ ﻉ ﻡ‬

Website: www.customs.gov.om :
MEASUREMENT ‫ﺍﻟﻘﻴﺎﺱ‬ COMMERCIAL REG. NO. ‫ﺭﻗﻢ ﺍﻟﺴﺠﻞ ﺍﻟﺘﺠﺎﺭﻱ‬ CARRIER'S NAME ‫ﺍﺳﻢ ﺍﻟﻨﺎﻗﻠﺔ‬
KG 1402123

NO. OF PACKAGES ‫ﻋﺪﺩ ﺍﻟﻄﺮﻭﺩ‬ EXPORT TO ‫ﺍﻟﻤﺼﺪﺭ ﺇﻟﻴﻪ‬ VOYAGE / FLIGHT NO. ‫ﺭﻗﻢ ﺍﻟﺮﺣﻠﺔ‬
3 CIGYSPOT TOBACCO TRADING FZE 4716/OM
CARRIER'S AGENT USE

TIN No. ‫ﺍﻟﺮﻗﻢ ﺍﻟﻀﺮﻳﺒﻲ‬

MARKS & NUMBERS ‫ﺍﻟﻌﻼﻣﺎﺕ ﻭﺍﻷﺭﻗﺎﻡ‬ B/L - AWB NO. / MANIF. ‫ﺍﻟﻤﻨﺎﻓﺴﺖ‬/‫ﺭﻗﻢ ﺍﻟﺒﻮﻟﻴﺼﺔ‬

PORT OF LOADING ‫ﻣﻴﻨﺎﺀ ﺍﻟﺸﺤﻦ‬

Wajajah Land Border
PORT OF DISCHARGE ‫ﻣﻴﻨﺎﺀ ﺍﻟﺘﻔﺮﻳﻎ‬ /
Jebel Ali Free Zone
DESTINATION ‫ﺟﻬﺔ ﺍﻟﻤﻘﺼﺪ‬
UNITED ARAB EMIRATES

‫ﺇﺟﻤﺎﻟﻲ ﺍﻟﺮﺳﻮﻡ‬ ‫ﻓﺌﺔ ﺍﻟﺮﺳﻢ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺑﺎﻟﻌﻤﻠﺔ ﺍﻟﻤﺤﻠﻴﺔ‬ CURRENCY ‫ﺍﻟﻌﻤﻠﺔ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺑﺎﻟﻌﻤﻠﺔ ﺍﻻﺟﻨﺒﻴﺔ‬ ‫ﺑﻠﺪ‬ ‫ﻭﺻﻒ ﺍﻟﺒﻀﺎﻋﺔ‬ ‫ﺑﻨﺪ ﺍﻟﺘﻌﺮﻓﺔ‬
TOTAL DUTY DUTY CIF LOCAL VALUE ‫ﺍﻟﺴﻌﺮ‬ ‫ﺍﻟﻨﻮﻉ‬ CIF FOREIGN
ORIGIN GOODS DESCRIPTION H.S. CODE
OMR RATE OMR RATE TYPE VALUE

Tobacco free single-use oral nicotine

CONSIGNEE OR CLEARING

E-mail : info@customs.gov.om :
9,505.188 100.000 9,505.188 0.385 USD 24,688.800 SE 240491300000 1
pouches (LYFT) and the li

Total : 9,505.188

AIP CUSTOMS RESTRICTIONS ‫ﺍﻟﻘﻴﻮﺩ ﺍﻟﺠﻤﺮﻛﻴﺔ‬

‫ﺭﻣﺰ ﺍﻹﻋﻔﺎﺀﺍﺕ‬ ‫ ﺿﺎﺭﺓ‬.‫ ﻡ‬.‫ ﻡ‬WEIGHT ‫ ﺍﻟﻮﺯﻥ‬CLASSIFICATION ‫ ﺍﻟﺼﻨﻒ‬PACKAGES ‫ﺍﻟﻄﺮﻭﺩ‬
‫ﺍﻟﺮﺳﻢ‬ ‫ﺍﻟﻨﺸﺮﺓ‬ ‫ﺍﻟﻘﺎﺋﻢ‬ ‫ﺍﻟﺼﺎﻓﻲ‬ ‫ﻭﺣﺪﺓ‬ ‫ﺍﻟﻜﻤﻴﺔ‬ ‫ﺍﻟﻨﻮﻉ‬ ‫ﺍﻟﻜﻤﻴﺔ‬ ‫ﻣﺮﺟﻊ ﺍﻟﻔﺴﺢ‬ ‫ﺍﻟﺠﻬﺔ‬
EXEMPTION OF DUTY CODE
Duty No GROSS NET UNIT QTY. TYPE QTY. RELEASE REF. AGENCY
765.000 324.000 KGM 324.000 Parcel 21,600.0
FRT INS
0.000 0.000

OMR ‫ ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ‬DUTY ‫ﺍﻟﺮﺳﻮﻡ‬ CLEARING AGENT ‫ﺍﻟﻤﺨﻠﺺ ﺍﻟﺠﻤﺮﻛﻲ‬ ‫ﺍﻟﺮﻗﻢ ﺍﻟﻤﺮﺟﻌﻲ ﺍﻟﻤﻮﺣﺪ‬
Unified Customs Code
9,505.188 CUSTOMS DUTY ‫ﺍﻟﻀﺮﻳﺒﺔ‬ ‫ﺍﻟﻤﺼﺪﺭ‬/‫ﻟﻠﻤﺴﺘﻮﺭﺩ‬
0.000 VAT ‫ﺃﺿﻮﺍﺀ ﺷﻨﺎﺹ ﺍﻟﺤﺪﻳﺜﺔ ﻟﻠﺘﺠﺎﺭﺓ‬
‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ‬
‫ﺍﻟﻤﻀﺎﻓﺔ‬
LICENCE NO. ‫ﺭﻗﻢ ﺍﻟﺮﺧﺼﺔ‬ 140212300000000C001898OM
0.000 EXCISE TAX ‫ﺍﻟﻀﺮﻳﺒﺔ ﺍﻻﻧﺘﻘﺎﺋﻴﺔ‬
Dumping Fee ‫ﺭﺳﻢ ﻣﻤﺎﺭﺳﺎﺕ‬ 2019/27559
‫ﺿﺎﺭﺓ‬
HANDLING ‫ﺭﺳﻮﻡ ﺍﻟﻤﻨﺎﻭﻟﺔ‬ ‫ﺭﻣﺰ ﺍﻟﻤﺸﻐﻞ ﺍﻻﻗﺘﺼﺎﺩﻱ‬
GCC AEO Code
0.000 OTHER ‫ﺃﺧﺮﻯ‬ ‫ﺍﻟﻤﻌﺘﻤﺪ ﺍﻟﺨﻠﻴﺠﻲ‬
EXIT PORT ‫ﺟﻤﺮﻙ ﺍﻟﺨﺮﻭﺝ‬
DEFINIT 15.002 ‫ﻗﻄﻌﻰ‬ ‫ﺍﺟﻤﺎﻟﻰ‬
INSURED 9,505.188 ‫ﺗﺄﻣﻴﻦ‬ TOTAL FEE

PAYMENT Online ‫ﻃﺮﻳﻘﺔ ﺍﻟﺪﻓﻊ‬

CUSTOMS USE

GUARANTEE/CHEQUE ‫ﺷﻴﻚ‬/‫ﺿﻤﺎﻥ‬
NO. ‫ﺭﻗﻢ‬
Other Remarks ‫ﻣﻼﺣﻈﺎﺕ ﺍﺧﺮﻯ‬
GREF310825996819
‫ﺭﻣﺰ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﺴﺮﻳﻌﺔ‬
QR CODE

DATE ‫ﺍﻟﺘﺎﺭﻳﺦ‬

RECEIPT PTN31082512187027 ‫ﺭﻗﻢ ﺇﻳﺼﺎﻝ ﺍﻟﺪﻓﻊ‬

DATE 31/08/2025 ‫ﺍﻟﺘﺎﺭﻳﺦ‬
BANK ‫ﺑﻨﻚ‬

: ‫ﺗﺄﺷﻴﺮﺓ ﺟﻤﺮﻙ ﺑﻠﺪ ﺍﻟﻤﻘﺼﺪ‬ : ‫ﺭﻗﻢ ﺍﻟﺴﻴﻞ ﺍﻟﺠﻤﺮﻛﻲ‬

I/We, Importer/Clearing Agent hereby declare that
all data and documents submitted are true and ‫ ﻭﻛﻴﻞ ﺍﻟﺘﺨﻠﻴﺺ ﺑﺄﻥ ﺍﻟﺒﻴﺎﻧﺎﺕ‬/‫ﻧﺤﻦ ﺍﻟﻤﺴﺘﻮﺭﺩ‬/‫ﺃﻗﺮ ﺃﻧﺎ‬ ‫ﻧﺆﻛﺪ ﻭﺻﻮﻝ ﺍﻟﺒﻀﺎﻋﺔ ﺗﻔﺎﺻﻴﻠﻬﺎ ﺃﻋﻼﻩ‬ ‫ﻧﺸﻬﺪ ﺑﺨﺮﻭﺝ ﺍﻟﺒﻀﺎﻋﺔ ﺗﻔﺎﺻﻴﻠﻬﺎ ﺃﻋﻼﻩ‬
REMARKS

complete. /‫ﻭﺍﻟﻤﺴﺘﻨﺪﺍﺕ ﺍﻟﻤﺮﻓﻘﺔ ﺻﺤﻴﺤﺔ ﻭﻛﺎﻣﻠﺔ ﻭﺳﻮﻑ ﺃﺗﺤﻤﻞ‬ :‫ﺑﺠﻤﺮﻙ‬ :‫ﺑﺠﻤﺮﻙ‬

I/We will bear any legal responsibility if the above
informations are not true. .‫ﻧﺘﺤﻤﻞ ﺃﻳﺔ ﻣﺴﺆﻭﻟﻴﺔ ﻗﺎﻧﻮﻧﻴﺔ ﻓﻲ ﺣﺎﻟﺔ ﺛﺒﻮﺕ ﻏﻴﺮ ﺫﻟﻚ‬ :‫ﺑﺘﺎﺭﻳﺦ‬ :‫ﺑﺘﺎﺭﻳﺦ‬
‫ﺍﻟﺨﺘﻢ ﻭ ﺍﻟﺘﻮﻗﻴﻊ‬ ‫ﺍﻟﺨﺘﻢ ﻭ ﺍﻟﺘﻮﻗﻴﻊ‬
Sultanate of Oman ‫ﺳﻠﻄﻨﺔ ﻋﻤﺎﻥ‬
Royal Oman Police APPENDIX ‫ﺷﺮﻃﺔ ﻋﻤﺎﻥ ﺍﻟﺴﻠﻄﺎﻧﻴﺔ‬
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Directorate General of Customs ‫ﺍﻻﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺠﻤﺎﺭﻙ‬

PORT ‫ﺍﻟﻤﻨﻔﺬ‬ DEC TYPE ‫ﻧﻮﻉ ﺍﻟﺒﻴﺎﻥ‬ DEC DATE ‫ﺗﺎﺭﻳﺦ ﺍﻟﺒﻴﺎﻥ‬ DEC NO. ‫ﺭﻗﻢ ﺍﻟﺒﻴﺎﻥ‬
Wajajah Land Border Export from Bonded Warehouse 31/08/2025 DECEBW31082511153679

CONVAYANCE DETAILS

S/No Gate Pass Number Plate Number Vehicle Plate Type Chassis Number Driver Name
‫ﺍﻟﺮﻗﻢ ﺍﻟﺘﺴﻠﺴﻠﻲ‬ ‫ﺭﻗﻢ ﺇﺫﻥ ﺍﻟﺒﻮﺍﺑﺔ‬ ‫ﺭﻗﻢ ﻟﻮﺣﺔ‬ ‫ﻧﻮﻉ ﻟﻮﺣﺔ ﺍﻟﻤﺮﻛﺒﺔ‬ ‫ﺭﻗﻢ ﺍﻟﺸﺎﺻﻲ‬ ‫ﺍﺳﻢ ﺍﻟﺴﺎﺋﻖ‬

1 284969 4716 COMMERCIAL WMA03WZZ2BM561004

SEAL DETAILS

SL. NO. ‫ ﺍﻟﺘﺴﻠﺴﻞ‬SEAL NO. ‫ ﺍﺭﻗﺎﻡ ﺍﻟﺮﺻﺎﺹ‬SEAL TYPE ‫ ﻧﻮﻉ ﺍﻟﺮﺻﺎﺹ‬SEAL TYPE ARABIC ‫ﻧﻮﻉ ﺍﻟﺮﺻﺎﺹ‬

2 1318455 Plastic Seal Non Chargeable (‫ﺭﺻﺎﺹ ﺑﻼﺳﺘﻴﻜﻲ )ﻣﻦ ﺩﻭﻥ ﺭﺳﻮﻡ‬

1 1318454 Plastic Seal Non Chargeable (‫ﺭﺻﺎﺹ ﺑﻼﺳﺘﻴﻜﻲ )ﻣﻦ ﺩﻭﻥ ﺭﺳﻮﻡ‬

ITEM SUMMARY
Duty OMR CIF VALUE OMR COO HS CODE
GROSS NET UNIT QTY. DESCRIPITION SL. NO.
‫ﺍﻟﻀﺮﻳﺒﺔ ﺍﻟﺠﻤﺮﻛﻴﺔ‬ ‫ ﺑﺎﻟﺮﻳﺎﻝ‬CIF ‫ﺍﻟﻘﻴﻤﺔ‬ ‫ﺷﻬﺎﺩﺓ ﺑﻠﺪ‬ ‫ﺭﻣﺰ ﺍﻟﻨﻈﺎﻡ‬
‫ﺍﻟﻮﺯﻥ ﺍﻟﻘﺎﺋﻢ‬ ‫ﺍﻟﻮﺯﻥ ﺍﻟﺼﺎﻓﻲ‬ ‫ﻭﺣﺪﺓ‬ ‫ﺍﻟﻜﻤﻴﺔ‬ ‫ﺍﻟﻮﺻﻒ‬ ‫ﺍﻟﺘﺴﻠﺴﻞ‬
‫ﺑﺎﻟﺮﻳﺎﻝ ﺍﻟﻌﻤﺎﻧﻲ‬ ‫ﺍﻟﻌﻤﺎﻧﻲ‬ ‫ﺍﻟﻤﻨﺸﺄ‬ ‫ﺍﻟﻤﻨﺴﻖ‬
Tobacco free single-use oral nicotine pouches (LYFT)
9505.188 9505.188 765 324.0 KGM 324.0 SE 240491300000 1
and the li

‫ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺍﻟﻮﺛﻴﻘﺔ ﻳﺠﺐ ﻣﺴﺢ ﺭﻣﺰ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﺴﺮﻳﻊ ﻟﻼﻃﻼﻉ ﻋﻠﻰ ﺍﻟﻮﺛﻴﻘﺔ ﺍﻻﺻﻠﻴﺔ ﻣﻦ ﻧﻈﺎﻡ ﺑﻴﺎﻥ‬

For verifying this document, please scan the QR code to view Original Document on Bayan system.