APPENDIX- 17

APPLICATION FOR GRANT OF EXPORT HOUSE/TRADING HOUSE/STAR TRADING HOUSE/SUPER STAR TRADING HOUSE


Note:

1. Please see Paragraph 3.7.2 of the Policy and Paragraph 3.2 of this Handbook.

2. Please read the general instruction given at Appendix 1 before filling this application.

3. Please submit 2 copies of this application form.


FOR OFFICIAL USE


File No.:-------------------------------- Date:-------------------------------




     1. Name and address      	:                                                                                             

     2. IEC Number            		:                                                                                             

     3. Application for       		: 
        EH/TH/STH/SSTH

     4. Branches (In India/Abroad) 	:



S.No.Name of the Place/CountryCode 


[1][2][3]


   


     5. Subsidiary Company		:



S.No.Company NameFOB value of exports


[1][2][3]


   



    * Documentary evidence as per company law substantiating that the company whose exports are taken 
       into account is actually the applicant’s subsidiary company.




 6. Details of Last three Export House/Trading House/ Star Trading House/Super Star Trading House Certificates issued earlier (if any).


S.No.Certificate number and dateValidity


  FromTo



   7. Statement of exports (licensing yearwise)




Licensing yearsFOB value of exports


  


  


  
DECLARATION


    1. I/We hereby declare that this application is based on the export performance of the preceding three licensing years or the present licencing year basis.

    [OLD -1. I/ We hereby declare that this application is based on the export performance of the preceding three licencing years basis. ]

    (Above S. No. 1. has been amended vide PN No. 53/2002-07, Dt. 31/12/2002)

    2. I/ We hereby declare that the FOB/ FOR value of exports of products shown above are our direct exports/ supplies and also the direct exports/ supplies of our subsidiary company which are true and correct and are in accordance with the accounts maintained by me/ us.

    (Declaration at S.No 1. and 2. of Appendix 17 has been corrected vide PN. No. 12(RE-02), Dt. 2/5/2002)

    [OLD
    1.I/We hereby declare that this application is based on the export performance of the preceding three licensing years/preceeding licensing year basis.

    2. I/ We hereby declare that the FOB value of Exports of Products shown above are our direct exports and also the direct exports of our subsidiary company and are true and correct and are in accordance with the accounts maintained by me/ us.]

    3. I/ We further certify that I/We am/are authorised to verify and sign the statement on behalf of the applicant.

    4. I/We fully understand that any information furnished in the above statement, if proved incorrect or false, will render me/us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.

    5. I/ We further declare that I/We has/have not applied nor obtained any recognition certificate as Export House/Trading House/ Star Trading House/Super Star Trading House from any other authority.

 							Signature______________________

                   						Name in Block letters _________
                                                                                 	Designation___________________

Place___________                              			Full Official 
							Address_______________________

                                                				Official 
Date____________                       				Stamp/ Seal
							Full Residential
							Address_______________________

							E.Mail No.____________________
CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/COMPANY SECRETARY

I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s............................ and their subsidiary company namely M/s...................... for the licensing period(s) ............. and hereby certify that:
(i)M/s ................................ and their subsidiary company namely M/s....................(full name and address of the applicant) have made the exports in the three preceding licensing years as specified in the statement of exports at Sl.No.7.

(Above S. No.(i) has been amended vide PN No. 53/2002-07, Dt. 31/12/2002)

[OLD-
M/s …………………………………and their subsidiary company namely M/s……….…… (full name and address of the applicant) have made the exports for each of the three preceding licencing years as specified in the statement of exports at Sl. No .

(S.No (i) of the Certificate of Chartered Accountant/Cost and Works Accountant/ Company Secretary under Appendix 17 has been corrected vide PN. No. 12(RE-02), Dt. 2/5/2002)

M/s ................................ and their subsidiary company namely M/s....................(full name and address of the applicant) have made the exports for each of the three preceding licensing years/during the preceding licensing year as specified in the statement of exports at Sl.No.7.]
(ii)The following documents/ records have been furnished by the applicant and their above mentioned subsidiary company and have been examined and verified by me/us namely :-Export Order/Contract, Shipping Bills, Bill of Lading (and/or Airways Bills/PP Receipts), Customs/Bank attested Invoices, Bank Certificates of exports made in their own name and connected books of accounts.
(iii)The relevant register has been authenticated under my/our seal/ signature.
(iv)The financial information given in the above statement is in agreement with the relevant register and records; the same has been incorporated in the books of accounts maintained by M/s.............and their above mentioned subsidiaries ; and is also true and correct.
(v)It has been ensured that the information furnished is true and correct in all respect; no part of it is false or misleading and no relevant information has been concealed or withheld;
(vi)Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;
(vii)I/We further certify that M/s.................... has realised 95% or more of the export proceeds in respect of exports made by him in the preceding three licensing years (excluding the export made during last six months from the date of filing of application) and 100% in the case of exports made in the current licencing year on the basis of which recognition is being claimed.

I/We hereby certify that the total value of outstanding export proceeds beyond a period of 6 months from the date of export made by the applicant

(Above S. No.(vii) has been amended vide PN No. 53/2002-07, Dt. 31/12/2002)

[OLD
M/s …………………………………and their subsidiary company namely M/s……….…… (full name and address of the applicant) have made the exports for each of the three preceding licencing years as specified in the statement of exports at Sl. No .

(S.No (vii) of the Certificate of Chartered Accountant/Cost and Works Accountant/ Company Secretary under Appendix 17 has been corrected vide PN. No. 12(RE-02), Dt. 2/5/2002)

I/We further certify that M/s.................... has realised 95% or more of the export proceeds in respect of exports made by him in the preceding three licensing years (excluding the export made during last six months from the date of filing of application) on the basis of which recognition is being claimed. I/We hereby certify that the total value of outstanding export proceeds beyond a period of 6 months from the date of export made by the applicant]
(viii)I/we fully understand that any statement made in this certificate, if proved incorrect or false, will render me/us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.
(ix)I/ We verify that in case the status of Export House is being claimed under the reduced export performance criteria of Rs. 5 crores average FOB/ FOR in the preceding three licencing years, the exports have been made by * (a)Units in Small Scale Industry/ (b) Tiny Sector/ (c)Cottage Sector or (d)Units registered with KVICs or (e)KVIBs or (f)Units located in North Eastern States, (g) Sikkim and (h)J&K or Units exporting (i) handloom, (j) handicrafts, (k) hand knotted carpets, (l)silk carpets or (m)exporters holding golden status or (n)exporters exporting to countries in Latin America and (o) CIS/ (p)sub Saharan Africa or (q)Units having ISO 9000 (series) status or (r)service exporters or (s) agri exporters (other than grains).

(* Strike out whichever are not applicable)
(S.No. (ix) has been added vide PN. No. 26/2002-07, Dt. 01/08/2002)




                                                                                 Signature.............................
Place:    .................. 
Registered..................
                                                       		Official Stamp/Seal

Date ...........
Regn. No.and Date of the
Corporate Membership..........
    If any of the documents of record mentioned in item (ii) of the certificates have not been maintained/furnished, examined or verified, they may please be specified below:-

    1.

    2.

    3.
(Pl. refer Trade Notice No. 07/2002, Dt. 17/07/2002 for - Table of five columns (Details of products exported, country of exports and dates of realisation) which is required for C.A.C. )

Documents to be enclosed with the application form:

    1. Self certified copy of valid RCMC.

    2. A certificate from Chartered Accountant/Cost and Works Accountant certifying the export/import performance in the prescribed format.

	Current residential address	:		Current official address	:
	Phone No.                  	:		Phone No.                  	:
	Fax No.                    	:		Fax No.                    	:
	E-Mail address             	:		E-Mail address             	: