Period
____________________________________________________________
Name of Authorised Dealer
________________________________________________
Currency
________________________________________________________
Sl.
No.
NAME OF EXPO-RTER
QUANTITY
AMOUNT
CODE
NUMBER
UNIT
UNIT CODE
VOLUME
Cr.
Lac
Th.
Unit
Country
Commodity
TOTAL
Signature and Stamp ofCoded
by: Authorised DealerChecked
by: Date ............................ ...........