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Customs Declaration Dispatch Note - CP 72

Click-N-Ship
usps.com

CJ175558802US00972321080200120

US POSTAGE PAID

Button
Commercial Base Pricing
Mailed from 75001

CJ 175 558 802 US
From
YE CHEN 14588 ASPEN CT ADDISON TX 75001-4462 USA

21 lb 8 oz

05/06/13

062S0000001307

License Number(s) Certificate Number(s) Invoice Number

Scheduled Delivery Date:

Insured Amount (US $)

SDR Value

$0.00
Nondelivery Instructions

WEIDONG ZHANG SHANGHAI STOCK EXCHANGE RM 2604, NORTH TOWER SHANGHAI STOCK EXCHANGE BUILDING NO.528 SOUTH PUDONG ROAD 200120 PUDONG, SHANGHAI, CHINA

Importer's Telephone/Fax/Email

Phone: 13501768435

Return to Sender
Comments (e.g., goods subject to quarantine, sanitary/ phytosanitary inspection, or other restrictions)

To

CHINA

Detailed description of contents
antistress kit house essentitional kit Joint house kit "See Continuation Sheet" Contents
Gift Documents Commercial Sample Returned Goods Merchandise Dangerous Goods Other

Qty.

Weight lb. oz.

Value (US $)

HS Tariff Number

Country of Origin

2 3 3 2

2 3 2 0

1 0 1 11

120.00 300.00 240.00 40.00
Total Value Total Postage/Fees Mailing Office Date Stamp

Total Wt.

Humanitarian Donation Explanation: nutritional supplements

21

8

$700.00

$97.23
May 6, 2013 75001

Sender's Customs Reference (if known)

Importer's Customs Reference - (Fiscal or VAT-number of the
addressee, if known)

AES/ITN/Exemption NOEEI 30.37(h)

I certify the particulars given in this customs declaration are correct. This item does not contain any undeclared dangerous articles, or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements under federal law and regulations. Sender's signature

POSTAL USE ONLY
Date In: Time In: AM PM Employee Initials:

YE CHEN

Date Do not duplicate this form without USPS approval.

05/06/2013

PS Form 2976-A-PMI

The item/parcel may be opened officially.

1 - Customs Declaration

Fold along line

CONTINUATION PAGE
CJ 175 558 802 US Detailed description of contents
weight loss pill
Qty. Weight lb. oz. Value (US $) HS Tariff Number Country of Origin

2

0

11

40.00

1 - Continuation

Customs Declaration Dispatch Note - CP 72

U.S. POSTAGE PAID COMMERCIAL BASE PRICING
Scheduled Delivery Date:

CJ 175 558 802 US
From
YE CHEN 14588 ASPEN CT ADDISON TX 75001-4462 USA

License Number(s) Certificate Number(s) Invoice Number

Insured Amount (US $)

SDR Value

$0.00
Nondelivery Instructions

WEIDONG ZHANG SHANGHAI STOCK EXCHANGE RM 2604, NORTH TOWER SHANGHAI STOCK EXCHANGE BUILDING NO.528 SOUTH PUDONG ROAD 200120 PUDONG, SHANGHAI, CHINA

Importer's Telephone/Fax/Email

Phone: 13501768435

Return to Sender
Comments (e.g., goods subject to quarantine, sanitary/ phytosanitary inspection, or other restrictions)

To

CHINA

Detailed description of contents
antistress kit house essentitional kit Joint house kit "See Continuation Sheet" Contents
Gift Documents Commercial Sample Returned Goods Merchandise Dangerous Goods Other

Qty.

Weight lb. oz.

Value (US $)

HS Tariff Number

Country of Origin

2 3 3 2

2 3 2 0

1 0 1 11

120.00 300.00 240.00 40.00
Total Value Total Postage/Fees Mailing Office Date Stamp

Total Wt.

Humanitarian Donation Explanation: nutritional supplements

21

8

$700.00

$97.23
May 6, 2013 75001

Sender's Customs Reference (if known)

Importer's Customs Reference - (Fiscal or VAT-number of the
addressee, if known)

AES/ITN/Exemption NOEEI 30.37(h)

I certify the particulars given in this customs declaration are correct. This item does not contain any undeclared dangerous articles, or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements under federal law and regulations. Sender's signature

POSTAL USE...
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