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Form

Form No.39

Document type
Form
Dated

Form of Certificate for baggage Shipped from a customs port

Form No.39

Customs Series Form No.39 

[See Notification No. 107-Cus., dated 9.9.1950]

                                                       CUSTOM HOUSE, 
                                                       Dated...... 19....

Certified that my baggage was shipped at a Customs port, namely............................ and that the same was

not transhipped from any other vessel from a Foreign port without payment of duty.


                                              (Signature)

                                       Passenger per. S.S."................."
		Address ....................

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