entryiimmediate delivery mi certified · .tassi department of the treasury united blates cu510ms...
TRANSCRIPT
. TASSI
DEPARTMENT OF THE TREASURYUNITED BlATES CU510MS SERVICE
I. AIIRlVAL OATE
100610IS. PORT
2095
TEL:
ENTRYIIMMEDIATE DELIVERY
Ii. S1N01.E TRANS. eOllO
MI CERTIFIED
AIR EXPRESS
4. I!NTRY NUMBER
112-9247186-3
111. u.s. PORT Of UNLADING 17. IMNIFF.Sr NUMBER 1a GO- NUMBER 19. TOTAL VALUE
F.;;20;=;;:9~5~===,....-- __....I- ---J- --.l-__l~1I{ij20. DESCRlI'TION OF MERCHANDISE
21. ITI8L.IAWll • IT/BUAWB NO.cooe
PHARMACEUTICALS NOT RESTRICTED
MH
TOTAL02358508380688760418425
Zl. CERTIFICATION
211. MANUfACTURER Ill.
BDREPHA176LON
28. CUSlOMS USE ONLY
I haraby maQ appllCllUon for entry/immediale delivery. I ooldrv Ihillihe IlboYo D OTHER AGENCY ACTION ReOUIRED, NAMELY:InfoRnl1llon Is aCC\lra19, Ibn bond I. Gul/kllenl, valid. and curmnl, and Ihal 011requlremanle 0119 CFR Part 142 have boen mel.
D CUSTOMS EXAMINAnON ReaUIRED.'-:-----,:-:----=~:...=..L-=..;:..L..-=-----1
------------------'--'--------1 D ENTRY REJECT'ED, BECAUSE:
DELIVERYAUTHORIZED:
SIGNATURE
Ptlparworll Rlldllclloll Act Nollce: Thll Infolml1llon I. needod to datennlno lite admr..lblilly ollmporta Into tho Unlllld 81"01 and to provide tho lI.cauAryInformallon lot the 8llftmlnetlal'l ollha CD a lind to ellllbilab thollabllHy lor pqyment 01 dullol Ind _ '!bur II!'5ponle Ie noeee.ary.
10/07/10 15:12:49 Customs Form 348' (010189)
FDA000023
Dream Pharma Ltd.
Invoice DetailsNumber: 26821NV
VAT no:Purc;hase Order;
1;6 Horn Lane, Aclon. london, WJ 6PJTel: 020 8992 7000 Fax: 020 8992 7001E-Mail: [email protected]
Date: 06-10-2010
Currenc)': GBP· Pounds sterlingHeading: PHARMACElITlCAlS NOT RESTRICTED
Order Details
Name/Descr. tionThiopental InJection , powder for rec;onstitutlon, thiopental sodium, 500·mg vial paclts of 25's
Balch No: AW6022 EXP: 05/14
Previous balance
Statement Details
,Deliver
InsuranceK~~l
Subtotal: (I1F~J
VAT (Wortd Zero): KIDIl~J
Previous Balance:Ii''i
Total: IIIIDTIaJB'GBP - Pounds Slerling
Pa ment Method: Pre a ent Tllank You
Shipping Details
Packiog:one boxTariff .. ,rnKGllL1,,"i'-----------+-::~~
Declarations:We certify Ihalthis invoice is true and correct.
Damage. shottlge or leakage mUll bO noVfied in WIlling 10 ours~..wKnln 3 d.ys. HDn-Oelivery \¥iohIA 14 doytl. Goods remain Ihe 1II0penr of DreamPharmalld. Unl~ filII paymenl h~8 been ~celv'ed. Subjeello our 81andard caNlilions orule. EaOE
Company RegistrationNumber~ VAT No.DireC10r: M. Alavi
Page 1of 1
FDA000024
ENTRY NUMBER: .. l:l.t 92.4718&3AWB/BL NBR : ~$1[(§ifID" INVOICE i
LINE CONSOLo WORKSHEET
PAGE: 110/07/2010
05:38 PM
ITEMS MARKEDTARIFFQTY 1:
**
LINE VALUE- GBP
**
****
*** END OF REPORT ***
FDA000025
ENTRY NUMBER: 112 9247186 3AWB/BL NBR ~ 1.1Iii{Q1rr~}~iJ~~ INVOICE #SHIPPER : DREAM PHARMA LTD
ITEM MARKED REFERENCE
PAGE; 110/07/2010
05:38 PM
INVOICE ITEMLINE# MARK
TARIFFNUMBER
COUNTRYOF ORIG. RATE OF DUTY
VALUE-GBP
1 1 GBQ:
KKK END OF REPORT ***
FDA000026
FDA000027
· . '
LOCATION MEM NEW INTERNATIONAL AIRBILL ENTRY ENT# 112-9247186-3
FDA000028