APPENDIX- 16
APPLICATION FORM FOR GRANT OF EXPORT LICENCE FOR ITEMS MENTIONED AS RESTRICTED FOR EXPORTS IN SCHEDULE II OF ITC(HS) CLASSIFICATIONS OF EXPORT AND IMPORTS ITEMS
Note:
1. Please read the general instructions given at Appendix 1 before filling this application.
2. Please submit 5 copies of this application form.
FOR OFFICIAL USE
File No.:-------------------------------- Date:--------------------------
1. Name and address of the applicant :
2. IEC Number :
3. Purpose of Export (Trade/ :
Personal/Sample)
4. Relevant Para of the Policy :
under which licence is sought
5. (i) Item of Export :
(ii) S.No under ITC(HS) :
Classification
(iii) Quantity applied for :
(iv) FOB value per unit :
(v) Total FOB value :
6. If the application is for export of :
seeds give the following additional
information:
(i) Details of seed/planting material :
proposed for export.
|
S.No. | Crop | Variety | Qty. in Kgs/ Number of pieces | FOB price per unit. |
| [1] | [2] | [3] | [4] | [5] |
| | | | | |
(ii) Whether seed/ Planting material :
proposed to be exported is
of notified variety.
(iii) Whether seed/planting material :
proposed to be exported has been
produced under custom production
arrangement? If so, enclose details/
agreement entered into with buyer
(iv) Whether the variety of seed/ planting :
material proposed to be exported is
used in India.
(v) Places whether the variety proposed :
to be exported is grown.
(vi) Any other relevant information. :
7. Details of the exports of the :
item applied for in preceding
three years (give information
in following form)
|
S.No. | Year | Licence no. and date | Qty. and value in US$ of the licence | Qty. and value in US$ of the item exported | Destination of export |
| [1] | [2] | [3] | [4] | [5] | [6] |
| | | | | | |
8. Export order No. & Date :
(Attach copy)
9. Name and address of the :
buyer
10. Port of shipment :
11. Destination of Export :
12. If application is for export :
of samples/exhibits/gifts
give the following details:
a) Ceiling Limit :
b) How much in excess of the :
ceiling limit.
c) Justification for excess. :
13. If export is by Post, :
Post Office where the parcel
will be placed.
DECLARATION/UNDERTAKING
I/we hereby solemnly undertake/declare that:-
(i) The particulars and the statements made in this
application and annexures attached thereto are true to
the best of my/our knowledge and belief and nothing has
been concealed or withheld therefrom.
(ii) Any licence granted on the basis of this application
shall be liable to cancellation or being made ineffective
without prejudice to any other action that may be taken
in this behalf under the Foreign Trade (Development and
Regulation) Act, 1992, or rules and orders made
thereunder and the Customs Act, 1962, if any information
furnished in this application is found to be wrong or
incorrect or misleading.
(iii)Any information furnished in the above statement, 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.
(iv)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.
(v)I hereby certify that I am authorised to verify and sign
this declaration as per Paragraph 9.9 of the Policy.
Place: Signature of the
Applicant --------------------
Date: Name in Block Letters --------------------
Designation --------------------
Official Address --------------------
Residential Address --------------------
E.Mail address ---------------------