Printed ANFs are indicative only. Wherever required, these are mandatorily to be filed on Portal only. |
ANF - 10C
APPLICATION FORM FOR EXPORT OF SCOMET ITEMS INCLUDING SOFTWARE AND TECHNOLOGY (UNDER GLOBAL AUTHORISATION FOR INTRA COMPANY TRANSFER) LISTED IN APPENDIX 3 TO SCHEDULE 2 OF ITC (HS) CLASSIFICATION
[Please see DGFT's Public Notice No. 14/2015-20 dated 13.06.2022 before filling the application)
1. Applicant Details:
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i IEC |
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ii. Name |
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iii. Address |
Flat/Plot/Block No. |
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Street/ Area/Locality |
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City |
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State |
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PIN Code |
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iv. Tele No. |
(1) |
Country Code |
Area Code |
Tel.No. |
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(2) |
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v. Mobile No. |
Country Code |
Area Code |
Fax No. |
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vi. E-mail address where alerts and notifications to be sent |
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vii. Company Website |
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viii. Principal Business Activities of the applicant firm : |
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ix. Is this applicant a parent company ? |
Yes |
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No |
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x. If applicant is a subsidiary, then provide following details : |
Name |
Address |
Country of Export (tick the appropriate) |
a. Parent Company |
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b. Other Subsidiaries (to which exports to be made) |
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xi. License exception given by (if applicable) |
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1. From Foreign parent/subsidiary |
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2. Name of the country |
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xii. Export license of foreign country (if applicable) |
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1. Type of Export license of foreign country (for e.g. bulk /general I temporary license I others) |
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2. Country of granting such license |
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Application Fee Details |
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i. Sr. No. |
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ii. Pay Mode |
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iii. Demand Draft/Bank/Bank Receipt/Electronic Fund Transfer |
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iv. Date of Issue |
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v. Name of the Bank on which drawn |
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vi. Bank Branch on which drawn |
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vii. Amount (Rs) |
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2A. Details of SCOMET items in Appendix 3 to Schedule 2 of ITC (HS) Classifications of Export & Import Items applied for export: ( If required, attach extra sheet (A4 size) in the same format) |
SI. No. |
SCOMET Category |
SCOMET Sub- ctegory
c |
Generics Descrip tion of export item/s including technical details |
Product Model No. / part No. |
ECCN/ number on the foreign export control list (If applicable) |
ITC (HS) Code No. (if available) |
Quantity |
Unit of Quantity (G,KG,no., Ltr or MT) |
Total FOB Value |
End Use Description |
In relevant Foreign Currency (other than USD) |
In Rupees |
In S$
c |
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2A. Details of SCOMET items in Appendix 3 to Schedule 2 of ITC (HS) Classifications of Export & Import Items applied for export: ( If required, attach extra sheet (A4 size) in the same format) |
SI. No. |
SCOMET Category |
SCOMET Sub- category |
Generics Description of export item/s including technical |
Product Model No. / part No. |
ECCN/ number on the foreign export control list (If applicable) |
ITC (HS) Code No. (if available) |
Quantity |
Unit of Quantity (G,KG,no., Ltr or MT) |
Total FOB Value |
End Use Description |
In relevant Foreign Currency (other than USD) |
In Rupee |
In S$ |
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SECTION B: CRYPTOGRAPHY NOTE (leave, if not applicable) i. Is the item available and sold from stock at 'retail selling points' without restrictions', to the general public' through any of the following means?
(a) Over -the-counter transactions
(b) Mail order transactions
(c) Electronic transactions
(d) Telephone call transactions
If yes, then provide details _____________________________________________________________
ii. Can the user easily change the cryptographic functionality of the item what is specified in the manufacture's specification? Yes No
iii. Is the item designed for installation by the user without further substantial support by the supplier? Yes No
SECTION C: TECHNICAL QUESTION (leave, if not applicable)
Does the item contain the following cryptographic functions?
1. A "symmetric algorithm" employing a key length in excess of 56 bits, not including parity bits? Yes No
If 'Yes' please state the following
a) Full name:
b) Key Length I bits:
c) Is it used for any of the following?
i. "Authentication"
ii. Digital Signature
iii. Data integrity
iv. Non-repudiation
v. Digital rights management, including the execution of copy protected software
vi. Encryption or decryption support of entertainment, mass commercial broadcasts or medical records management
vii. Key management in support of any of the cryptographic functions in above 1. (i) to (vi)
d) Encryption algorithm
e) Encryption Functionality
Additional Information (If applicable)
2C. In case ofTechnologyand Software (If applicable) ( If required, attach extra sheet (A4 size) in the same format) |
SI. No. |
sco MET category |
Name of the manufacturer/ Producer/ Service Provid |
Brand (If appli cable ) |
Name of Model or Name of Software/ Technology |
Model no./ Part No. (If applica ble) |
Class (If applicable) |
Type (If applicable) |
Serial No. (If applicable) |
Version No. (If applicable) |
Encryption algorithm (If applicable) |
Encryption Function ality (lf applicable) |
Value of technology |
Additional lnformation (if any) |
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2D. Company's Information |
S. No. |
SCOMET category |
Purpose of export/re-export (e.g Design/ encryption /research/ development/delivery/ validation /testing/ repair /demo /display/calibration/ others (Please specify) |
Name of the company to which export/re- export to be made |
Is it foreign parent company/subsidiary Or Indian Parent/Subsidiary |
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3. Shipment Details (in case of physical export)
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i. Port of Loading/Shipment |
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ii. Port of Discharge |
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iii. Countries* to which item to be exported |
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1. |
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2. |
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iv. Ultimate Destination Country* |
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1. |
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2. |
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*Insert additional row or sheet, if required for more number of countries
4. Details of exports of SCOMET items Detailsof the export last made, if no export was made during the preceding licensing year):( If required, attach extra sheet(A4size)in the same format) |
SI. No. |
Export License No. & Date |
Details of items exported |
Quantity exported |
Country to which exported |
DGFT's (HQ's) File Number |
Category |
Description |
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5. Shipment Details (In case of Intangible Transfer of Technology (ITT)) |
i. Mode of Export |
Over the counter transactions |
Mail Order Transactions |
Electronic transactions |
Telephone call transactions |
Others |
ii. Countries to which item to be exported |
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iii. Ultimate Destination Country |
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6A. Consignee* Details (If different from ultimate end user)
* The DGFT need to be informed in advance in case of any new consignee is involved.
i. Name |
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ii. Address |
Flat/Plot/Block No. |
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Street/ Area/Locality |
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City |
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Country |
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Postal Code |
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iii. Tele phone No. |
(1) |
Country Code |
Area Code |
Tel.No. |
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(2) |
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iv. Fax No. |
Country Code |
Area Code |
Fax No. |
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v. E-mail |
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6B. Intermediary* Details (If third party involved) (leave if not applicable)
* The DGFT need to be informed in advance in case of any new intermediary is involved.
i. Name |
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ii. Address |
Flat/Plot/Block No. |
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Street/ Area/Locality |
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City |
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Country |
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Postal Code |
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iii. Tele phone No. |
(1) |
Country Code |
Area Code |
Tel.No. |
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(2) |
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iv. Fax No. |
Country Code |
Area Code |
Fax No. |
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v. E-mail |
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7. Please indicate the type of supporting documents submitted (via email, fax or post) to DGFT (hqrs). Please number all pages of the supporting documents and indicate the total number of pages at the top right corner of every page. Please note that failing to submit the necessary documents will delay the processing.
c Technical drawings {Information on Product/Technology) ,wherever applicable
c Technical Specifications/Data Sheets/Brochures of the product(s) , wherever applicable
c Documentary Proof that establishes corporate relationship between Intra companies i.e. between foreign parent company/subsidiary of parent company/Indian parent company/ Subsidiary of Indian parent company
c Documentary Proof that establishes contractual agreement between foreign parent/subsidiary and/ or Indian parent/subisidiary with the third party involved in the supply chain, wherever applicable.
c Relevant Undertakings and Declaration, where applicable
c Purchase Order(s)/Contract Agreement(S)/ Copy of Master Service Agreement (MSA)/Warranty Policy Conditions
c Export Licence(s) from DGFT, wherever applicable.
c Export request Letter, where applicable
c Documentary Proof of License Exception granted by the export control licensing authority of country of the foreign parent company with validity (wherever applicable)
c Export license of foreign country (wherever applicable)
c A self-certified copy of the ICP of the foreign parent company being adopted by Indian subsidiary/ self-certified copy of ICP of Indian parent company/ ICP certified by Government like AEO Scheme
c Proof of repair obligation in India (Wherever applicable)
c Proof of demonstration purpose (wherever applicable)
c Other, Please specify............................
For Use in DGFT office only (To be filled by the applicant).
9A. Application Submission Details (if submitted electronically):
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i. GAICT Registration no. |
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ii. File Number & Date of Issue |
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iii. Application Fee submission details viz. Amount in Rupees, Demand Draft No./Electronic Fund Transfer No. and Date and the name & branch of the bank on which drawn |
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98. Jurisdictional Regional Authority (from where the company has been issued IEC or having branch office) |
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DECLARATION/UNDERTAKING
1. I/We hereby certify that:
(i) I/We hereby declare that the particulars and the statements made in this application are true and correct to the best of my I/our knowledge and belief and nothing has been concealed or held there from.
(ii) I/We fully understand that any information furnished in the application if found incorrect or false will render me liable for any penal action or other consequence as maybe prescribed in law or otherwise warranted.
(iii) I/We undertake to abide by the provisi ons of the FT(D&R)Act, 1992, as amen ded, the Rules and Orders framed there under , FTP, HBP, Appendices and Aayat Nryat Forms and ITC{HS).
(iv) I/ We hereby certify that:
A. The entity for whom the application has been made have not been penalized under any of the following Acts (as amen ded from time to time):
(i) The Customs Act , 1962,
(ii) The Central Excise Act1 , 1944
(iii) Foreign Trade (Development & Regulation) Act 1992, as amended , and
(iv)The Foreign Exchange Management Act, 1999
(v) The Conservation of Foreign Exchange , Prevention of Smuggling Activities ; Act, 1974
(vi) Weapons of Mass Destruction & their Delivery Systems (Prohibition of Unlawful Activities) Act, 2005
B.None of the Directors/Partners/Proprietor/Karta/Trustees of the comp any/firm/HUF/Trust, (as the case may be), is/are a Director(s)/Partner(s)/Proprietor/ Kartal/ Trustee in any other Company/ firm I entity which is on the Denied Entity L st (DEL) of DGFT or is in the caution list of RBI;
C. Neither the Registered Office of the company I Head Office of the firm I nor any of its Branch Office(s)/ Unit(s)/ Division(s) has been declared a defaulter and has otherwise been made ineligible for undertaking import I export under any of the provisions of the Policy;
D. We have neither obtained nor applied for issuance of an Importer Exporter Code Number in the name of our Registered I Head Office to any other Licensing Authority.
(v) I/We hereby declare that I/We have neither obtained nor applied for such benefits (including issuance of an Importer Exporter Code Number)in the name of our Registered I Head Office or any of our Branch(s) Unit(s) Division(s) to any other Regional Authority.
(vi) We have complied with the conditions of all previous licences/authorizations issued to us for export of SCOMET items and wherever required have duly intimated the J/o DGFT , New Delhi along with documentary evidence regarding receipt of the items of export by the end-user within the stipulated time.
(vii) I/We undertake to abide by the provisions of the FT(D&R)Act , 1992, as amended , the Rules and Orders framed there under , FTP, HBP and ITC (HS) and submit all requisite documents to the o/o DGFT(SCOMET Section) ,failing which 1/We shall liable to action under FT(D&R)Act, 1992 as amended or rules and orders made the under , and the Customs Act , 1962.
Signature of the Applicant |
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Name |
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Designation |
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Official Address |
Flat/Plot/Block No. |
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Street/Area/Locality |
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City |
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State |
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PIN Code |
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Telephone |
Country Code |
Area Code |
Tel.No. |
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Place: |
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Date: |
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