SADPMR Form PMR 7 - Import permit holder declaration of import transactions

Quarter / Year: SOUTH AFRICAN DIAMOND AND PRECIOUS METALS REGULATOR 251 Fox Street; Doornfontein; Johannesburg 2001, South Africa Name of Permit Holder: Form Permit Number: P. O. Box 16001, Doornfontein 2028 PMR 7: Tel (011)223 7000, Fax (011) 334- 8833; Email: PM_registers@sadpmr.co.za IMPORT Physical Address: PERMIT HOLDER Telephone Number/s: I, the undersigned licensee, solemnly declare that the transactions in this register are correct and complete Fax Number : Signed: _________________________________________________ Email Address: Registration Number/ Client Code: Date of declaration:______________________________________________ Precious Metals Imported (unwrought and semi-fabricated) Date of Precious Metal Nature: form & Purity in which precious metal was Imported (2) Origin (country) of Precious Metals (3) Fine Mass (g/kg etc.) of Value in (R) of Precious Import Imported (1) Precious Metals (4) Metals transaction * A true copy of this declaration of import transactions for each quarter (Q) of a calendar year must be submitted to the (1) Precious Metal Imported (e.g. gold, platinum, palladium, rhodium, iridium, osmium, or ruthenium) regulator by 15 April (for Q1), 15 July (for Q2), by 15 October (for Q3) and by 15 January (for Q4) (2) Nature: Form and Purity (e.g., unwrought bars of 99.5% purity) (3): Country imported from (Attach bill of entry) (4): Fine mass/weight: the mass of the precious metal contained in the article/product, as determined by multiplying the gross weight of the article/product by its fineness or purity (in%)

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