The Standards (Imports Registration and Batch Certification) Regulations, 2021

1. Point of Entry:......................…………...………………………………………….……… ……

2. Product (s) Name: ............………………………………………………………….……………

3. Quantity:…..……...………….…………................................................................ ..............

4. Invoice No:.......................................................................................…………………………...

5. Bill of lading/ RCN/ Airway bill: ..............…...……………………………………..……………..

6. Name and Address of Importer: .....................…… ……………………………………………..  District/Town:……......................….................................................................... ..............  Plot No:……………...................…..…….………………………….......................... ..........  Street:…………………................…………………………………….……… …………….  Name of Main road:……................………..………………………………………………...  Famous neighborhoods:…..................…..……………………………………………… …...  Importer’s ID type..…................…………………ID No:………………………...………… Telephone No...…..........….….….Mobile  No……..…...............................................…….  E-mail address:……………………………………………………………...…………...

7. Specific location/Warehouse where goods under conditional release are kept ........................................................................  Famous neighborhoods:……………………………………………………................……  Sketch map of the location. 44 Standards (Imports Registration and Batch Certification) GN. NO. 681 (Contd.)

8. Name and Address of Clearing agent: ……………………………………………………...  Telephone No: ……………….......... ID No: …………………………………...  Mobile No: ……………………….........……………………………………….  E-mail address: ……………………..…………………………………………… IMPORTERS DECLARATION: I declare that the consignment /goods above shall not be distributed, sold, used or transferred until the test results is out and in case of failure of the product to meet requirements of the standards consignment will be returned to the originating country/destructed at owner’s cost. NOTE: Any person who contravenes any of these regulations commits an offence and on conviction, shall be liable to imprisonment for a term not less than two years or to a fine not less than fifty million shillings and not exceeding one hundred million shillings or to both. ……………………….. .........……....… ................................. Importername Signature Date ……………………….. ...................……….... .………………. Agentname Signature Date FOR OFFICIAL USE ONLY: Remarks……………………………………………………………………………… ……………………………………………………………………………………… …………………………………… …………… TBS Inspector ……………………… ……………… Signature Date. Dodoma, KITILA A. MKUMBO 1st September, 2021 Minister for Industries and Trade 45