APPENDIX - 11C
APPLICATION FORM FOR DUTY ENTITLEMENT PASS BOOK (DEPB) ON POST EXPORT BASIS
Note:
1. Please see Paragraph 7.38 of this Handbook
2. Please read the general instructions given Appendix 1 before filling this application.
3. Please submit 2 copies of this application form.
FOR OFFICIAL USE
F.No. ............................ Date:..........
1. Name and address of the applicant :.............................................................
..............................................................
2. IEC Number : ........................................
3. FOB value of exports In figures :Rs. ..........................
In words :Rs............................
4. Total DEPB entitlement claimed In figures :Rs. ..........................
In words :Rs. .............................
5. Application fee Rs. ......................................
Bank Receipt/DD No.& date : ........................................
Issued by : ........................................
........................................
6. Details of exports made
Sl.No | S/Bill No and Date | FOB value as per S/Bill | Customs House | Date of Export | Bank Certificate No. and date | Product Group Code No. | Sl.No.of DEPB Rate List (App.28A) | Description as per S/Bill |
(1) | (2) | (3) | (4) | 4(a) | (5) | (6) | (7) | (8)e |
| | | | | | | | |
FOB as per Bank Certificate including the commission,Upto the specified limit. | Unit of Measurement of Value Cap | FOB value per Unit of Measurement | Value Cap | Base Value for computation of DEPB (lower of 9 b & 9 c) | Net Quantity Exported | DEPBRate | Value of DEPB claimed(Rs.) |
(9) | 9 a | 9 b | 9 c | 9 d | 9 e | (10) | (11) |
| | | | | | | |
(In above table Column Nos. 9a to 9e has been added vide
P.N. No. 33(RE-01), Dt. 7/8/2001.)
Total:
Note: For Product Group Code No. refer to Appendix-1.
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 hereby declare that no DEPB has been claimed earlier pertaining to the particulars of the
Shipping Bills given above.
(5) 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.
(6) I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 3.8 of
the Policy.
(7) I/We further declare that in case of non realisation of export proceeds or lesser realisation of
export proceeds, we shall pay, in cash, an amount equivalent to the duty free import benefits
availed against DEPB entitlement already obtained on the non realised or lesser realised value of
export proceeds together with 24% interest reckoned from the date of duty free imports to the
date of payment (Applicable only in case of exports made against irrevocable Letter of Credit).
Signature of the Applicant .....................
Name: .....................
Designation: .....................
Official address: .....................
.....................
Tele No: .....................
E.Mail address .....................
Date:
Place :
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 E.P Copy of DEPB shipping Bills.
3 Bank Certificate of Exports and Realisation in Appendix-25.