APPENDIX - 17D
APPLICATION FORM FOR DUTY FREE ENTITLEMENT TO STATUS HOLDERS
(Please see paragraph 3.7.2.1(vi) of the Policy and 3.2.5 of the Handbook)
FOR OFFICIAL USE
| File No.:-------------------------------- | Date:------------------------------ |
| 1. | Name and address | :...................................
...................................
...................................
|
| 2. | I E Code Number | : ...................................
|
| 3. | Status | : Export House [ ]
Trading House [ ]
Star Trading House [ ]
Super Star Trading House [ ]
|
| 4. | Status Certificate Number | : ...................................
|
| 5. | Status Certificate valid upto | : ...................................
|
| 6. | Details of Exports:
|
| Exports in free foreign exchange | Export Growth rate (in %) | Incremental export in value terms (in rupees) | Duty free Credit Entitlement |
| 2002-03 | 2003-04 |
| (1) | (2) | (3)= {[(2)-(1)]/(1)}*100 | (4)* | (5)=0.1*(4) |
| | | | | |
(* Note: (The foreign exchange to be converted into Indian rupees as per exchange rate notified by DGFT for relevant currencies).
7. Port of Registration (for import purposes) :-----------------------------
(Above S.No. 7. has been added vide
PN. NO. 18/2003, DT. 24/07/2003)
DECLARATION
1. I/We hereby declare that this application is based on exports earned in free foreign exchange during the licencing year 2002-03 and 2003-04.
2. I/We further certify that I/We am/are authorised to verify and sign the statement on behalf of the applicant.
3. 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.
4. I/We further declare that I/We has/have not applied nor obtained another duty entitlement certificate issued under paragraph 3.8 of the Policy based on the exports in free foreign exchange during the preceding three licensing year.
5. I/We further declare that I/We shall comply with the provisions of the Exim Policy/Handbook of Procedure (Vol.1) and the relevant Customs notification while importing the goods under the scheme and subsequent use of the same under actual user condition.
6. I/We further declare that in respect of capital goods and/or office equipments,a certificate from jurisdictional Deputy Commissioner Central Excise/Assistant Commissioner of Central Excise or an independent Chartered Accountant, as the case may be, shall be produced confirming installation and use of capital goods and/or office equipments in the importer’s factory or premises, within six months from the date of imports or within such extended period as the said Deputy Commissioner of Customs or Assistant Commissioner of Customs may allow.
(Above Declaration has been amended vide
PN. NO. 18/2003, DT. 24/07/2003)
[OLD-
1. I/We hereby declare that this application is based on exports earned in free foreign exchange during the licencing year 2002-03 and 2003-04.
2. I/We further certify that I/We am/are authorised to verify and sign the statement on behalf of the applicant.
3. 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.
4. I/We further declare that I/We has/have not applied nor obtained another Duty Entitlement Certificate issued under paragraph 3.7.2.1(vi) of the Policy based on the exports in free foreign exchange during 2002-03 and 2003-04.
5. I/We further declare that in case of non realisation of export proceeds or lesser realisation of export proceeds in free foreign exchange, we shall pay, in cash, an amount equivalent to the duty free credit entitlement already obtained on the non realised or lesser realised value of export proceeds together with 15% interest reckoned from the date of duty free imports effected under duty free entitlement certificate to the date of payment.
]
| | Signature | :............................. |
| Name in Block Letters | :............................. |
| Designation | :............................. |
| Place | :............................. |
| Date ......... | Full Official Address | :............................. |
| Residential Address | :............................. |
| E.Mail address | :.............................
Official
Stamp/Seal |
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................. for the licensing period(s) ..... and hereby certify that:
i) M/s............................... (Name and address of the applicant) who is a Export House/Trading House/Star Trading House/Super Star Trading House have earned foreign exchange during the licensing years, 2002-03 and 2003-04 as per the details supplied in the details of exports at Sl.No.6.
ii) The following documents/records have been furnished by the applicant and their above mentioned subsidiary company for verification of the export details and have been examined and verified by me/us namely: (Tick whichever is applicable and give details)
a) Bank Certificate of foreign exchange earning/FIRCs,
b) Any other document (please specify).
iii) 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.
iv) 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;
v) Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;
vi) 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.
(* Strike out whichever are not applicable)
Place..........
Date...........
Regn. No. and Date of the
Corporate Membership.......... | Signature.............................
Tel.No. ............................
Official
Stamp/ Seal |
Documents to be enclosed with the application form:
1. Copy of the status holder certificate.
2. Copy of the balance sheet filed with Income Tax Authorities for the relevant year or CA certificate from the statutory authorities.
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