EXAMINATION REPORT FOR FACTORY SEALED PACKAGES/CONTAINER

1. Name of Exporter : CTX LIFESCIENCES PVT. LTD.

BLOCK NO. 251-252 SACHIN MAGDALLAROAD,GIDC,SACHIN,
SURAT, GUJARAT, INDIA

2. (a) IEC No. : 5204013458

(b) Branch Code N.A.
(c) BIN (PAN based Bus. Ident. No. of the exporter)
3. Name of the manufacturer (if different from the exporter) : CTX LIFESCIENCES PVT. LTD.
4. Factory address : BLOCK NO. 232 TO 234, 251/B, 252
PAIKEE, 253 TO 255,256/P, 258/P, 276/P, 277, 278/P, 279 TO 282,
283/P, 284/P, G.I.D.C. SACHIN SURAT 394230
5. Date of examination : 13.02.2017
6. Name & desig.of the examining officer-Inspector/EO/PO : NIKHIL MODI (Inspector)
7. Name & desig.of the supervising officer-Appraiser/ Supdt. : MAYUR BHAI (Superintendent )
8. (a) Name of Commissionerate/Division/Range : Range :II-SACHIN,Division:III, Commissionerate:SURAT II
(b) Location Code** 391102
9. Particulars of export Invoice
(a) Export Invoice No. : PI/10000286 DT:13.02.2017
(b) ARE1 No. & Date : 1422/2016-17 DT: 13.02.2017

(c) Total No. of packages : 11

(d) Name and address of the consignee abroad LLOYD LABORATORIES INC
10 LLOYD AVENUE, FIRST BULACAN INDUSTRIAL CITY BRGY.
TIKAY,
PHILIPPINES
10. (a) Is the description of the goods, the quantity and their value as : Yes
per particulars furnished in the export invoice? :
(b) Whether sample is drawn for being forwarded to Port of : Yes
export?
(c) If yes, the number of the seal of the package containing the : 2
sample
11. Central Excise/Customs Seal Nos.
(a) For Non-containeraised cargo Seal Nos. : ---

No. of packages :
(b) For Containerised Cargo Seal No. EXCISE 123456
12. Total Gross Wt. of the Consignment : NET WT : 97.000 KG
GROSS WT : 128.540 KG

Container Number Size No. of Packages stuffed in container

GSTU - 12345- (6) 20 Feet 7 HDPE DRUM,4 FIBER DRUM.

Stuffing Permission No:S/6-Gen-564/08-09 Exp FSP dt:21.08.2008

SIGNATURE OF EXPORTER SIGNATURE OF SIGNATURE OF

INSPECTOR / EXAMINER APPRAISER / SUPERINTENDENT
For CTX LIFESCIENCES PVT. LTD.