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Date
Address
Date & Time
Purpose
Officer Name
Owner Name
Officer Signature
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ACKNOWLEDGEMENT
I,
[Owner Name]
, (Name of owner or occupant), acknowledge that officers from Singapore Customs have explained to me the purpose of the visit to the premises stated in Section A. I confirm that nothing was taken from the premises, except for the items that were handed over for investigation vide Acknowledgement Receipt
Owner Signature
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