Note:
1. Please see Paragraph 8.2, 8.37 and 8.38 of the Policy and Paragraph
8.2, 8.32 and 8.79, 8.88 of this Handbook.
2. Please read the general instructions given in Appendix -1 before filling
this application.
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FOR OFFICIAL USE
File No. :.................................. Date ..............
CIF value of Licence issued ........... Licence No. and Date ..........
...........................................................................
1. Name and address of Applicant :..................................
..................................
2. IEC Number :..................................
2(A) PAN Number :..................................
3. Export proceeds realisation Month :.................................
4. Total FOB value of Exports (in figure) :................................
(In free foreign exchange) / Rupee
(in words) :.................................
5. Value of Licence claimed (in figure) :................................
(In free foreign exchange / Rupee)
(in words) : ...............................
6. Application Fee Rs. ........................................
Bank Receipt / Demand Draft No. and Date ................................
Name of the bank and issuing branch :................................
| Name of the bank | S. No. in Shipping Bill/postal receipt |
Date of Export | Amount of Exports Proceeds Realised |
Country of Exports | FOB Value(in foreign exchange)/rupees |
Value of the REP Licence Claimed |
1.
a.
b. | | | | |
| |
2.
a.
b. | | | | |
| |
3.
a.
b. | | | | |
| |
(Note: The above stated table is not required to be filled up in case of an
application for Replenishment licence under para 8.88 of this Handbook)
DECLARATION / UNDERTAKING
........................
1. I / We hereby declare that the particulars and the statements made
in this application are true and correct to the best of my / our
knowledge and belief and nothing has been concealed or held
therefrom.
2. I / We fully understand that any information furnished in the
Application if proved incorrect or false will render me / us
liable for any penal action or other consequences as may be
prescribed in law or otherwise warranted.
3. I / We undertake to abide by the provisions of the Foreign Trade
(Development and Regulation) Act, 1992, the Rules and Orders
framed thereunder, the Export and Import Policy and the Handbook
of Procedures.
4. I / We declare that outstanding realisation of export proceeds beyond
180 days does not exceed 10% of average exports of preceeding three
licensing years. I / We further declare that no export proceeds are
outstanding beyond the period of one year or such extended period for
which RBI permission has been obtained.
5. I hereby certify that I am authorised to verify and sign this
declaration as per Paragraph 3.8 of the Policy
Place : Signature of the Applicant:.................
Date :
Name: ................
Designation: ................
Official Address: ................
................
Tele.No.:
Residential Address: ................
................
Email Address : ..................
.............................................................
Documents to be enclosed with the application form:
.............................................................
1. Bank Receipt (in duplicate) / Demand Draft evidencing payment
of application fee in terms of Appendix-34.
2. Bank certificate of export and realisation in the form given
in Appendix - 25 evidencing realisation of exports
proceeds / sales proceeds.
3. Export Promotion copy of shipping bill (s). (Photocopy of the EP copy
of Shipping Bill duly endorsed may be returned for utilisation / re-import
purposes when the exports are made on consignment basis.
4. Customs attested invoice
5. I case of application for Replishment licence under paragraph 8.88
of this Handbook, an applicant will be required to submit documents as
given at s. No.1 above and Statemnt of Exports made during the preceding
year duly certified by Chartered Accountant / Cost & Works Accountant.