Singapore Customs,
55 Newton Road #07-01,
Revenue House
Singapore 307987
Tel No. : 6355 2000
Fax No. : 6355 2134
Email: customs_ttsb@customs.gov.sg
SC-A-012 (Ver 8 – 11 / 15)
DECLARATION OF FACTS FOR MOTOR VEHICLES
This form may take you 5-10 minutes to fill in.
You will need the following information to fill in the form:
(a) Registration & De-Registration Paper
(b) Completion Inspection Certificate (CIC) Paper
(c) Data Card
(d) Option List (where applicable options should be listed down in detail and supported by invoice / letters from supplier)
(e) Trade Documents (e.g. Invoice, Bill of Lading, Freight and Insurance Paper)
* Delete as appropriate
SECTION A
IMPORTER’S DETAILS
(1)
Name of Importer:
(3)
Address:
(4)
Tel No.:
SECTION B
(7)
(8)
(2) Importer’s UEN:
(5) Fax No.:
(6) E-mail:
PARTICULARS OF THE VEHICLE AND ITS SUBSEQUENT SALE
Make / Model:
Date of Manufacture:
* Auto / Manual Transmission
(9) Engine Capacity:
(10) Engine No.:
(11) Chassis No.:
(12) Colour Code:
(13) Package Code:
(14) Model Code:
(15) Name of Subsequent Buyer:
(16) Vehicle’s Current Location:
(17) Address of Subsequent Buyer:
SECTION C
PLEASE PROVIDE THE FOLLOWING SUPPORTING DOCUMENTS (WHERE APPLICABLE)
(18) CIC Paper:
(19) Data Card:
(20) Supplier’s letter on options fitted in vehicle:
(21) Registration Paper / De-Registration Paper:
(22) Others, please specify:
SECTION D
COMPUTATION OF CUSTOMS VALUE (SUPPORTING DOCUMENTS MUST BE ATTACHED)
(23) Invoice Price:
* EXW / FOB / CFR / CIF
(24) Cost of Accessories:
(25) CFR:
(26) Registration Charges:
(27) Insurance:
(28) De-Registration Charges:
(29) CIF:
(30) Freight Charges:
(31) Exchange Rate Used:
(32) Other Charges:
SECTION E
(i)
(ii)
(iii)
(iv)
(v)
DECLARATION
I hereby certify that all the above particulars declared by me are true and correct.
The declaration is made on the basis that price is the sole consideration.
There is no restriction on the use of the goods and price is not subject to conditions or considerations for which a value cannot
be determined.
No part of the proceeds of any subsequent resale, use or disposal of the motor vehicle will accrue directly or indirectly to the
supplier.
The price is not influenced by the relationship between the supplier and importer.
(33) Name:
(34) Signature & Date:
(35) Designation:
SECTION F
FOR OFFICAL USE ONLY
(36) * NRIC / Passport No. :
(37) Product Code:
(38) Customs Value:
(39) Invoice No(s) :
(40) No. of Unit(s) :
SC-A-012 (Ver 8 – 11/15)
Per Unit
Page 1 of 1