Customs Act 1901 CEO Instrument of Approval No. 18 of 2005 (Cth)

COMMONWEALTH OF AUSTRALIA

CEO Instrument of Approval No. 18 of 2005

Customs Act 1901

I, LIONEL BARRIE WOODWARD, Chief Executive Officer of Customs, under section 4A and paragraph 119A(2)(c) of the Customs Act 1901 (the Act), approve the attached EXPORT DECLARATION WITHDRAWAL NOTICE (No. B611 (FEB 2005)) as an approved form for the purposes of communicating to Customs a documentary withdrawal of an export declaration under section 119A of the Act.

CEO Instrument of Approval No. 16 of 2004 is revoked.

This instrument commences on the day it is registered.

Dated: 7 April 2005

LIONEL BARRIE WOODWARD

Chief Executive Officer of Customs

EXPORT DECLARATION

WITHDRAWAL NOTICE

Approved Form - Customs Act Paragraph 119A(2)(c)

NOTICE This information is required under Section 119A of the Customs Act 1901. To ensure accurate balance of trade and taxation records, the information you provide will be given to the Australian Bureau of Statistics and the Australian Taxation Office. If you are required to hold a permit to export these goods, the export declaration details will also be given to the relevant permit issuing agency.

WITHDRAWAL NOTICE

I hereby withdraw the export declaration identified by the following particulars (as shown in the original declaration)

Export entry advice number (also known as an Export Declaration Number)

Sender Reference (your reference)

DECLARATION
I hereby declare that I, the undersigned, or the organisation for whom I work made the original declaration and I am the:
Owner (including an employee of the owner)
Agent of the Owner
I further declare that I am authorised to withdraw the export declaration identified above and that the information provided within this form is completed and correct.
Name of Person making the Withdrawal
Contact Address
Contact Phone Number		Contact Fax Number		Contact Email
Company Name					Position in Company
Signature						Date / /

B611 (FEB 2005)