RENCANA IMPOR DAN EKSPOR DAN KEBUTUHAN BARANG DAN BAHAN IMPOR SELAMA 12 BULAN

NAMA PERUSAHAAN   : .....................................................

NPWP   : ...................................................................................

                         PERIODE   : ..............................................................................

RENCANA PRODUKSI/HASIL OLAHAN/EKSPOR
KEBUTUHAN BARANG/BAHAN IMPOR
No.Urut
No. HS
URAIAN BARANG EKSPOR
SATUAN
JUMLAH
NO. URUT
No.HS
URAIAN BARANG IMPOR
SATUAN
JUMLAH
1
2
3
4
5
6
7
8
9
10

Perkiraan nilai bea masuk yang diminta untuk di bebaskan Rp..........,00(.....................)

            Pimpinan Perusahaan,                                            a.n. Menteri Keuangan                                                                                                 Direktur Jenderal Bea dan Cukai

            ................................                                                     ..............................

            (Cap Perusahaan)                                                          (Cap Dinas)

                                                                                                 Menteri Keuangan

                                                                                                              ttd,

                                                                                                  Bambang Subianto

LampIII. ....................