Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - I - SHIPPING BILL SUMMARY
[Link] [Link] [Link] [Link] [Link] [Link] [Link] [Link] [Link] [Link]-EXP [Link]
STATUS
SEA N Y N Y Y Y N N N
A
[Link] OF LOADING INNSA1 (Jawaharlal Nehru (Nh) [Link] OF FINALDESTINATION TAJIKISTAN
[Link] OF ORIGIN Maharashtra [Link] OF FINAL DESTINATION TJDYU (Dushanbe)
PY
[Link] OF DISCHARGETJDYU (Dushanbe) [Link] OF DISCHARGE TAJIKISTAN
[Link]'S NAME & ADDRESS [Link] NAME & ADDRESS
INFUGEN PHARMA PRIVATE LIMITED UKYONUSPHARM LLC
B DECLARAN
PREMISES NO. 4, BUILDING NO. 31, GR RURAL COMMUNITY,RED STAR
DETAILS
ARIHANT COMPLEX, NEAR KOPER BUS STO VILLAGE OF PAKHTAKOR, YAVAN DISTRIC TKHATLAN DUSHANBE,
CO
BHIWANDI [Link] Private TJ
3. AD CODE: 0230067 8. GSTIN / TYPE 27AABCI2131G1Z1 GSN
[Link] WAIVER NO.& DT [Link] BANK A/C NO. 60XXXXXX845
[Link] NAME OMKAR EXPRESS LOGISTICS PVT LTD [Link] BANK A/C NO. 60XXXXXX845
[Link] 11. IFSC NO. MAHB0000020
[Link] VALUE [Link] [Link] [Link] [Link] [Link] CLAIM 2. IGST AMT [Link] AMT
SUMMA
E MANIFEST [Link]
[Link].
723466.89 0 0 0 0 6868 97179.53
D.
[Link] 7.P/C [Link] [Link] [Link] VALUE [Link] AMT [Link] AMT
RT
0 0 723466.89 6133 0
[Link] NO. [Link] DT [Link] NO. [Link] DT N.O.C. [Link] [Link] NO. 3. INV AMT. [Link]
DETAILS
[Link]
1 INF2324/GEP00165 8795.95 USD
4. CIN NO. 5. CIN DT. 6. CIN SITE ID SUMMARY
24PCEG04081126830600 08-APR-24 INNSA1
PO
[Link] [Link] [Link] 4.S No [Link] [Link] NO [Link] DT [Link]
CHALLAN DETAILS
G. EQUIPMENT
DETAILS
EX
H
T
[Link] TYPE [Link] OF CARGO [Link]. OF PACKETS [Link]. OF CONTAINERS [Link] PACKETS
I. ANNEX
DETAILS
WAREHOUSE SEALED CONTAINERISED 513 0 0
LE
[Link] & NUMBERS AS PER INVOICE ("WE INTEND TO CLAIM REWARDS UNDER REMISSION OF DUTIES AND TAXES ON
EXPORTED PRODUCTS (RoDTEP)")
[Link] [Link] [Link] [Link] NO. 20/35
[Link]
[Link] 30-MAR-24 20:19 [Link] Date. 08-APR-24
DETAILS
[Link] [Link] Realisation Date 31-JAN-25
[Link] 08-APR-24 13:12
[Link] 08-APR-24 14:29
Signature Not Verified
Digitally signed by DS DIRECTORATE GENERAL
OF SYSTEMS AND DATA MANAGEMENT 01
Date: 2024.04.08 [Link] IST
Reason: CUSTOMS
Location: INDIA
Glossary
A: ASSESS - Assessed, EXMN - Examined, MEIS - Merchantise Export Incentive Scheme, DBK - Drawback, ROSL - Rebate of State Levies,
DEEC - Duty Exemption Entitlement Certificate, DFRC - Duty Free Replenishment Certificate,LUT - Letter of Under Taking. B: CB - Customs Broker
AD Authoized Dealer , AEO - Authorized Economic Operator, UCR - Unique Customs Reference C: DISCOU - Discount, COM - Commission,
P/C Packing Charges,D: EX. PR.- Export Promotions E: MAWB / HAWB - Master / House Airway Bill Number J:BRC- Bank Realisation Certificate
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Page 1 Of 6
Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - II - INVOICE DETAILS
[Link] [Link] No. & Dt. [Link]. & Dt. [Link] No. & Dt [Link] No.&Dt [Link] code [Link]
REF
A.
1 INF2324/GEP00165 29/03/2024 0230067 FOB
[Link]'S NAME & ADDRESS [Link]'S NAME & ADDRESS
INFUGEN PHARMA PRIVATE LIMITED LLC KAND
Y
PREMISES NO. 4, BUILDING NO. 31, GR DUSHANBETAJIKISTAN
B. TRANSACTION
ARIHANT COMPLEX, NEAR KOPER BUS STO
PARTIES
421302
OP
[Link] PARTY NAME & ADDRESS [Link] AEO STATUS
[Link] VALUE
TC
[Link] VALUE 3FREIGHT [Link] [Link] 8.P/C [Link] RATE
[Link]
DTLS
8795.95 8795.95 0 0 0 0 0 0 1 USD INR 82.25
USD USD USD USD USD USD USD
[Link] [Link] CD [Link] [Link] [Link] [Link] [Link](F/C)
1 30049099 PHARMACEUTICAL PRODUCT-- CALCILYSIN-D3 S 11075 NOS .6046 6695.95
YRUP (MULTIVITAMINS MINERALS AND L-LYSIN E
OR
SYRUP)
2 21069099 PHARMACEUTICAL PRODUCT-- ROTARITE D3 VIT 10000 NOS .21 2100
AMIN D3 DROPS (HEALTH SUPPLEMENT)
XP
TE
D. ITEM DETAILS
LE
Glossary
A: Ref - Reference P.O. - Purchase Order, LoC - Letter of Credit, AD - Authorised Dealer C: VAL DTLS - Valuation Details
FOB - Freight On Board, DEDUCT - Deduction , P/C - Packing Charge D: HS CD - Harmonized System Code, UQC - Unit Quantity Code
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Page 2 Of 6
Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - III - ITEM DETAILS
1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 1 30049099 PHARMACEUTICAL PRODUCT- 11075 NOS .6046 6695.95 550741.92 54.7
- CALCILYSIN-D3 S YRUP
(MULTIVITAMINS MINERALS
AND L-LYSIN E SYRUP)
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
PY
Y P 550741.89 66089.03 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 4939.45 KGS Maharashtra NASHIK
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
CO
NCPTI 0 INR GNX100 Y Yes N
1INVSN 2ITEMSN [Link] CD [Link] [Link] 6UQC [Link] 8VALUE(F/C) [Link] (INR) [Link]
1 2 21069099 PHARMACEUTICAL PRODUCT- 10000 NOS .21 2100 172724.97 19
- ROTARITE D3 VIT AMIN D3
DROPS (HEALTH
SUPPLEMENT)
[Link] [Link] RT 13CESAMT [Link] [Link] 16. IGST VALUE 17. IGST AMOUNT 18SCHCOD
RT
Y P 172725 31090.5 19
19. SCHEME DESCRIPTION 20. SQC MSR 21. SQC UQC 22. STATE OF ORIGIN 23. DISTRICT OF ORIGIN
Drawback 333.5 KGS Himachal Pradesh SOLAN
24. PT Abroad [Link] CESS [Link] USE [Link] BENEFIT AVAILED 28. REWARD BENEFIT 29. THIRD PARTY ITEM
NCPTI 0 INR GNX100 Y Yes N
PO
INVOICE (1/1)
T EX
LE
GLOSSARY
FOB - Freight On Board, HS CD Harmonized System Code, UQC - Unit Quantity Code, PMV - Present Market Value, CESAM - Cess Amount
IGSTSTA - IGST Payment Status, VAL - IGST Value, PAID - IGST Amount Paid, SCHCOD - Scheme Code, SQC MSR - Standard Quantity
Measurement, comp - compensatory, PT Abroad - Preferential treatment Availed Abroad
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Page 3 Of 6
Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - IV - EXPORT SCHEME DETAILS
A. DRAWBACK & ROSL CLAIM
[Link] SNO [Link] SNO [Link] SNO. [Link]/WT [Link] [Link] [Link] AMT [Link] [Link] [Link] AMT
1 1 3004B 11075 550741.92 1.2 6608.9 0 0 0
1 2 2106B 10000 172724.97 .15 259.09 0 0 0
B. AA / DFIA LICENCE DETAILS
Y
[Link] SNO [Link] SNO [Link] NO [Link] OF EXPORT ITEM [Link] SNO [Link] [Link] [Link] VALUE
[Link] [Link] OF IMPORT ITEM 11IMP SNO 12IMPQT [Link] [Link] / IMP
OP
C. JOBBING DETAILS
[Link] NO [Link] DATE [Link] CODE [Link] OF IMPORTED GOODS [Link] IMP [Link] USED
D. SINGLE WINDOW DECLARATION
TC
[Link] [Link] [Link] [Link] [Link] CD [Link] TEXT [Link] MSR [Link]
1 1 DTY RDT RODTEPY Claimed 4939.45 KGS
1 1 ORC EPT NCPTI
1 1 DTY GCESS 0 INR
1 1 ORC STO 27
OTHER ADDITIONAL INFORMATION
1 1 ORC DOO 487
OR
1 1 CHR SQC 4939.45 KGS
1 2 DTY RDT RODTEPY Claimed 333.5 KGS
1 2 ORC EPT NCPTI
1 2 DTY GCESS 0 INR
1 2 ORC STO 02
1 2 ORC DOO 025
XP
1 2 CHR SQC 333.5 KGS
E. SINGLE WINDOW DECLARATION - CONSTITUENTS
[Link] 3.C SNO [Link] [Link] [Link] [Link] PCT [Link]
F. SINGLE WINDOW DECLARATION - CONTROL
TE
[Link] [Link] TYPE [Link] [Link] DT [Link] DT [Link] CD [Link] TEXT
[Link] DOCUMENTS
[Link] 3 DOCTYPCD 4. ICEGATE ID 5. IRN [Link] CD [Link] PLA [Link] DT [Link] DT
1 0 380000 OMKAREXPRESSLO 2024033000148716 29-MAR-24
LE
1 0 271000 OMKAREXPRESSLO 2024033000145840 29-MAR-24
1 0 934000 OMKAREXPRESSLO 2024033000145841 29-MAR-24
1 0 935000 OMKAREXPRESSLO 2024033000145843 30-MAR-24
1 1 022CO1 OMKAREXPRESSLO 2024033000145842 29-MAR-24
1 1 003000 OMKAREXPRESSLO 2024033000148717 18-MAR-22
[Link] DETAILS
[Link] [Link] NO [Link] AMOUNT [Link]
1 INF2324/GEP00165 8795.95 USD
[Link] DETAILS
[Link] [Link] [Link] [Link]
J.AR4 DETAILS
[Link] [Link] 3.AR4 NUMBER 4.AR4 DATE [Link] [Link] [Link]
Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla
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Page 4 Of 6
Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - IV - EXPORT SCHEME DETAILS
K. THIRD PARTY DETAILS
[Link] [Link] [Link] 4. EXPORTER NAME 5. ADDRESS [Link] ID AND TYPE
L. ITEM MANUFACTURER/PRODUCER/GROWER DETAILS
[Link] [Link] [Link] CD [Link] STATE [Link] CY [Link]
Y
M. RODTEP DETAILS
OP
[Link] 3. QUANTITY 4. UQC 5. NO. OF UNITS 6. VALUE
1 1 4939.45 KGS 1 4406
1 2 333.5 KGS 1 1727
N. REEXPORT DETAILS
[Link] [Link] [Link] SITE ID [Link] [Link] [Link] INV SNO [Link] ITEM S 8. BE QTY 9. BE UQC
TC
OTHER ADDITIONAL INFORMATION
OR
XP
TE
LE
Glossary
INVSN - Invoice Serial Number ITMSN - Item Serial Number A: DBK - Drawback, ROSL - Rebate of State Levies, B: DFIA - Duty Free Import
Authorization, EXP - Export , IMP - Import , UQC-Unit Quanity CodeFOB - Freight On Board D: INFO - Information CD - Code MSR - Measuremen
E: ING - Ingredient F : RES CD - Result Code, RES TXT - Result Text ST DT -Start Date G: IRN - Image Reference Number CD - Code PLA - Pla
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Page 5 Of 6
Port Code SB No SB Date
INDIAN CUSTOMS EDI SYSTEM INNSA1 8783103 30-MAR-24
CENTRAL BOARD OF INDIRECT TAXES AND CUSTOMS IEC/Br 3104000034 6
DEPARTMENT OF REVENUE - MINISTRY OF FINANCE GSTIN/TYPE 27AABCI2131G1Z1 GSN
GOVERNMENT OF INDIA CB CODE AABCO8873HCH001
TYPE INV ITEM CONT
Nos 1 2 0
JNCH, NHAVA SHEVA, TAL:URAN, DIST-RAIGAD-400707 PKG 513 [Link] KGS 5632.05 * SB22080420241429
PART - V - DECLARATIONS
Y
OP
TC
A. DECLARATION STATEMENT
OR
XP
TE
LE
B. AUTHORIZED
SIGNATORY
DATE AUTHORIZED SIGNATORY CHA NAME :AABCO8873HCH001
PLACE
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