FORM - XXXVIII

Department of Commercial Taxes, Government of Uttar Pradesh

[See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2011-2012/18012102168241 10/02/2012 Agra Sector-15, DC 09702302171 Date(w.e.f) 28/01/1997 Date of Expiry 10/05/2012

M/S TRELA FOOTWEAR EXPORTS PVT.LTD. D-38,SITE-C,INDUSTRIAL AREA,SIKANDRA C.P.W 3000 KG. 12 185130.00 Rupees One Lakh Eighty Five Thousand One Hundred Thirty Only 296/11-12 20/03/2012 AGRA DEE ARR ENTERPRISES 4273 A, JAI MATA MARKET DELHI 07080263104

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. MUSKHAN TEMPO SERVICE 176, VILLAGE BHALSWA, DELHI 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. DL-lL-R-0911 4. Name & address of Driver VEERPAL N.A 5. Driving License No. 35238 6. Signature of the vehicle driver. Demand No : 12189990302487 Single(Original) Printed On : 25/03/2012 18:13:33

FORM - XXXVIII

Department of Commercial Taxes, Government of Uttar Pradesh

[See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2011-2012/18012102168241 10/02/2012 Agra Sector-15, DC 09702302171 Date(w.e.f) 28/01/1997 Date of Expiry 10/05/2012

M/S TRELA FOOTWEAR EXPORTS PVT.LTD. D-38,SITE-C,INDUSTRIAL AREA,SIKANDRA C.P.W 3000 KG. 12 185130.00 Rupees One Lakh Eighty Five Thousand One Hundred Thirty Only 296/11-12 20/03/2012 AGRA DEE ARR ENTERPRISES 4273 A, JAI MATA MARKET DELHI 07080263104

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. MUSKHAN TEMPO SERVICE 176, VILLAGE BHALSWA, DELHI 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. DL-lL-R-0911 4. Name & address of Driver VEERPAL N.A 5. Driving License No. 35238 6. Signature of the vehicle driver. Demand No : 12189990302487 Single(Second) Printed On : 25/03/2012 18:13:34