APPENDIX -10A
APPLICATION FORM FOR GRANT OF LICENCES FOR CAPITAL GOODS INCLUDING COMPUTER, COMPUTER SUB-SYSTEMS AND SERVICE EQUIPMENT UNDER THE EPCG SCHEME
- Note:
- Please see paragraph 6.2 of this Handbook.
- Please read the general instructions given at Appendix-1 before filling this application.
- Please submit 10 copies of this application form.
FOR OFFICIAL USE
| File Number:........................ | Date:........ |
| 1. | IEC Number | :...................
|
| 2. | Name and address of the applicant | :M/s....................................
|
| 3. | Application for (Tick the relevant column) :
|
| a) | (i) EPCG Scheme on FOB basis | : [ ] |
| (ii) EPCG Scheme on NFE basis | : [ ]
|
| b) | (i) Manufacturer Exporter | : [ ] |
| (ii) Merchant Exporter | : [ ] |
| (iii) Service Provider | : [ ]
|
| 4. | Category of service provider
(If applicable) | : [ ]
|
| 5. | (i) | Name of the end products to be manufactured out of the proposed capital goods.
|
| (ii) | Product(s) to be exported :
|
| (iii) | Export Product Group Code :
|
| 6. | (i) | CIF Value of the licence: applied for. | (In Rupees)............
(In freely convertible currency) .............
|
| (ii) | Export obligation under taken:
|
| (In freely convertible currency) | .....................
|
| 7. | Application fee details | : Rs...............
Bank Receipt/DD No.......
and date
Issued by................
|
| 8. | i) Name of the applicant or his supporting manufacturer(s)/ vendor(s) and Address of factory where the capital goods to be imported are proposed to be installed | : ....................................
.................................
...............................
|
ii) The manufacturing products endorsed on SSI/ Industrial Licence/IEM.
|
| iii) Whether any export obligation has been imposed in the Letter of Intent/ Industrial Licence/ FC Approval. | Yes/No
|
| If yes, give details thereof including E.O fulfilled, if any | : ...................................
|
| 9. | Capital investment on fixed assets : |
| | Existing | Proposed
|
| A. | Land and Building | Rs........... | Rs...........
|
| B. | Machinery/Equipments
|
| (i) Imported (CIF Value) | Rs........... | Rs...........
|
| (ii) Indigenous | Rs........... | Rs...........
|
| (iii) CIF value of CG applied for | Rs........... | Rs...........
|
| (iv) Total of (i)+(ii)+(iii) | Rs........... | Rs...........
|
| Total : | Rs........... | Rs...........
|
| 10A | Any change in the status of SSI limit due to import of capital goods proposed to be imported under this scheme: | (a) Not applicable /c
(b) No change/c
(c) Crosses SSI limit c
|
| 10B. | Whether the firm has any confirmed commitment from any foreign buyer for exports,if yes, give details
|
| 11. | Details of exports made/services rendered for the same on similar export product during preceding three licensing years. |
| LICENSING YEAR | FOB VALUE OF EXPORTS
(in Rupees) | PRODUCTS EXPORTED |
| [1] | [2] | [3] |
| | | |
| 12. | Customs duty on capital goods to be imported | Duty leviable under EPCG scheme | Duty saved (in Rupees) |
| | | | |
| 13. | Details of EPCG Licences already obtained: |
| S.No. | Licence No. and date | CIF value(In Rupees) | Export obligation fixed in freely convertible currency | Whether BG/ LUT submitted | %age of export obligation fulfilled |
| | | | | | |
| 14. | Details of capital goods applied for import : |
| S.No. | Description and technical specification of the items of import | Quantity | CIF value in freely convertible currency (FOB+Frieght+Insurance) | Country of origin |
| (1) | (2) | (3) | (4) | (5) |
| | | | | |
DECLARATION/UNDERTAKING
I/We hereby solemnly undertake/declare that:-
- 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.
- I/We full 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.
- 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.
- That I/We shall be liable to penal action in accordance
with the Policy/Procedure/Foreign Trade (Development &
Regulation) Act, 1992 the Rules and Orders framed
thereunder and the Customs Act,1962 addition to
forfeiture of Bank Guarantee or any other
Bond/Guarantee given to the Customs, in the event of
failure to fulfil the export obligation as stipulated,
within the export obligation period prescribed or
subsequently extended by the competent authority.
- I/We further declare that no export proceeds are
outstanding beyond the prescribed period as laid down
by the RBI ,or such extended period for which RBI
permission has been obtained.
- I hereby certify that I am authorised to verify and
sign this declaration as per Paragraph 3.8 of the
Policy.
| | Signature of the Applicant:.............
|
| Name: ................. |
| Designation: ................. |
| Official Address: ................. |
.................
|
| Tel.No.: ................. |
| Place : | Residential Address: ................. |
| Date : | .................
|
| | E.Mail Address:..................... |
Documents to be enclosed with the application form:
- Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-34.
- Self certified copy of the Performa invoice/quotations. of the foreign supplier showing separately (i) the amount on account of freight and (ii) insurance included in the CIF value quoted. In case the Proforma invoice is on FOB basis,the applicant shall indicate the freight and insurance separately in the application form.
- Manufacturers illustrated pamphlets/catalogue.
- Statement of exports achieved by the applicant in respect of the same/similar export product/services rendered during the preceeding three licensing years duly certified by a Chartered Accountant/ Cost and Works Accountant in the form given in Appendix-26.
- (a) Self certified copy of SSI registration certificate/ Industrial Licence/Letter of intent or I.E.M.acknowledgement filed with the Secretariat for Industrial Assistance.
OR
(b) In case of service provider, a proof indicating the profession to which the applicant belongs.