APPENDIX - 17

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APPLICATION FOR GRANT OF EXPORT HOUSE/TRADING HOUSE/STAR TRADING HOUSE/SUPER STAR TRADING HOUSE

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Note:

1. Please see Paragraph 3.7.2 of the Policy and Paragraph 3.2 of this Handbook.

2. Please read the general instruction given at Appendix 1 before filling this application.

3. Please submit 2 copies of this application form.

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FOR OFFICIAL USE

File No.:--------------------------------

Date:-------------------------------

1.	Name and address	:
2.	IEC Number	:
3.	Application for EH/TH/STH/SSTH	:
4.	Branches (In India/Abroad)	:

S.No.	Name of the Place/Country	Code
[1]	[2]	[3]

5. Subsidiary Company:

S.No.	Company Name	FOB value of exports
[1]	[2]	[3]

* Documentary evidence as per company law substantiating that the company whose exports are taken into account is actually the applicant’s subsidiary company.

6. Details of Last three Export House/Trading House/ Star Trading House/Super Star Trading House Certificates issued earlier (if any).

S.No.	Certificate number and date	Validity
		From	To

7. Statement of exports/deemed supplies (licensing yearwise)

Licensing years	FOB value of exports	FOR value of deemed supplies

DECLARATION

1. I/We hereby declare that this application is based on the export performance of the preceding three licensing years or the present licencing year basis.

2. I/ We hereby declare that the FOB /FOR value of Exports of Products shown above are our direct exports/ supplies and also the direct exports/ supplies of our subsidiary company and are true and correct and are in accordance with the accounts maintained by me/us.

3. I/ We further certify that I/We am/are authorised to verify and sign the statement on behalf of the applicant.

4. I/We fully understand that any information furnished in the above statement, if proved incorrect or false, will render me/us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.

5. I/We further declare that I/We has/have not applied nor obtained any recognition certificate as Export House/Trading House/Star Trading House/ Super Star Trading House from any other authority.

	Signature______________________ Name in Block letters ____________ Designation____________________
Place___________	Full Official Address_______________________ Official
Date____________	Stamp/ Seal Full Residential Address_______________________ E.Mail No._____________________

CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/COMPANY SECRETARY

I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s............................ and their subsidiary company namely M/s...................... for the licensing period(s) ............. and hereby certify that:

(i) M/s ................................ and their subsidiary company namely M/s....................(name and address of the applicant) have made the exports in the three preceding licensing years as specified in the statement of exports at Sl.No.7.

(ii) The following documents/ records have been furnished by the applicant and their above mentioned subsidiary company and have been examined and verified by me/us namely:-Export Order/Contract, Shipping Bills, Bill of Lading (and/or Airways Bills/PP Receipts), Customs/Bank attested Invoices, Bank Certificates of exports made in their own name and connected books of accounts.

(iii) The relevant register has been authenticated under my/our seal/ signature.

(iv) The financial information given in the above statement is in agreement with the relevant register and records; the same has been incorporated in the books of accounts maintained by M/s.............and their above mentioned subsidiaries ; and is also true and correct.

(v) It has been ensured that the information furnished is true and correct in all respect; no part of it is false or misleading and no relevant information has been concealed or withheld;

(vi) Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;

(vii) I/We further certify that M/s.................... has realised 95% or more of the export proceeds in respect of exports made by him in the preceding three licensing years (excluding the export made during last six months from the date of filing of application)and 100% in the case of exports made in the current licencing year on the basis of which recognition is being claimed. I/We hereby certify that the total value of outstanding export proceeds beyond a period of 6 months from the date of export made by the applicant

(viii) I/we fully understand that any statement made in this certificate, if proved incorrect or false, will render me/us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.

(ix) I/ We verify that in case the status of Export House is being claimed under the reduced export performance criteria of Rs.15 crores [Deleted - average ] FOB/ FOR in the preceding three licencing years or the current licensing years, the exports have been made by * (a)Units in Small Scale Industry/ (b) Tiny Sector/ (c)Cottage Sector or (d)Units registered with KVICs or (e)KVIBs or (f)Units located in North Eastern States, (g) Sikkim and (h)J&K or Units exporting (i) handloom, (j) handicrafts, (k) hand knotted carpets, (l) silk carpets or (m)exporters holding golden status or (n)exporters exporting to countries in Latin America and (o) CIS/ (p)sub Saharan Africa or (q)Units having ISO 9000 (series)/WHOGMP/HACCP/SEI CMM level-II and above status granted by agencies listed in Appendix-28A or (r)service exporters or (s) agri exporters (other than grains).

(In Sl. No. (ix) word "average" stand Deleted vide PUBLIC NOTICE NO. 36(RE-03), DT. 10/12/2003)

(* Strike out whichever are not applicable)

Place: .................. Registered..................	Signature............................. Official Stamp/Seal
Date ........... Regn. No.and Date of the Corporate Membership..........

If any of the documents of record mentioned in item (ii) of the certificates have not been maintained/furnished, examined or verified, they may please be specified below:-

1.

2.

3.

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Documents to be enclosed with the application form:

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1. Self certified copy of valid RCMC.

2. A certificate from Chartered Accountant/Cost and Works Accountant certifying the export/import performance in the prescribed format.

3. Bank certificate of export realisation/deemed exports for status certificate as per Appendix-17B.

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