I, the importer whose information is stated below, request approval to release My shipment is: ...................................
The following shipment, listed in import statement number ............ and dated ..........., is exempted from customs fees according to the Industrial Exemption Decision number 666/ص dated 07/05/1430 H attached to the import statement. I hereby declare to the Customs authority that I will not use the items exempted for any other purpose than the one for which they were imported, nor will I exchange, sell or dispose of them in any way without official approval from Customs to pay any applicable customs fees. I understand that violating this declaration would constitute customs smuggling and subject me to penalties under the Unified Customs Law of the Gulf Cooperation Council countries, approved by Royal Decree No. (M/41) dated 03/11/1423 H. I also understand that Customs officials have the right to inspect my warehouses and factories, and review any documents and records related to these materials at any time they see fit (without objection or delay from me) to ensure compliance with this declaration and to confiscate any non-compliant materials (if any) as a prelude to implementing customs smuggling penalties against me in accordance with the Unified Customs Law of the Gulf Cooperation Council countries. This is my acknowledgement thereof.