APPENDIX- 17-A
APPLICATION FOR GRANT OF ONE TO FIVE STAR EXPORT HOUSE FOR SERVICE PROVIDERS
Note:
1. Please see Note-1 of paragraph 3.5.2 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.
FOR OFFICIAL USE
File No.:-------------------------------- Date:-------------------------------
1. Name and address : .........................................................................................................
2. I E Code Number : ...................................
3. Application for Star Export House for service providers : ......................................................................
4. Statement of gross foreign exchange earning direct and indirect sources (Licensing year wise):
| Licensing year | Category of service provider | Description of services provided | Gross foreign exchange earnings (direct and indirect sources) |
| (1) | (2) | (3) | (4) |
| | | | |
DECLARATION
1. I/We hereby declare that this application is based on the foreign exchange earning direct and indirect of the preceding three licensing years and current licensing year on gross foreign exchange.
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 any recognition certificate as status holder from any other authority.
| Signature | : | .............................
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| Name in Block Letters | : | .............................
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| Designation | : | .............................
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| Place | : | .............................
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| Date | : | .............................
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| Full Official Address | : | .............................
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| 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............................... (Full name and address of the applicant) have earned foreign exchange earning direct and indirect sources each of the three preceding licensing years/during the current licensing year as specified in the statement of gross foreign exchange earning at Sl.No.5.
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: Bank Certificate of direct foreign exchange earning, FIRCs, certificate from international credit card companies etc. and C.A certificate for the indirect sources.
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 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.
viii) I/ We verify that in case the status of Export House is being claimed under the reduced export performance criteria of Rs. 5 crores average FOB/ FOR in the preceding three licencing 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 as listed in Appendix 17 C and (o) CIS/ (p)sub Saharan Africa or (q)Units having ISO 9000 (series)/ WHOGMP/ HACCP/ SEI CMM level II and above status or (r)service exporters or (s) agri exporters (other than grains).
(* Strike out whichever are not applicable)
Place..........
Date........... | Signature.............................
Tel.No. ............................
Official Stamp/ Seal
Regn. No. and Date of the Corporate Membership.......... |
Documents to be enclosed with the application form:
1. Self certified copy of a) project approval or b) classification approval of Department of Tourism or c) Any other registration. However, for Hotels, RCMC from FIEO is acceptable.
2. A certificate from Chartered Accountant/Cost and Works Accountant certifying the export/import performance in the prescribed format.
3. Copy of the FIRC issued by the Bank in respect of foreign exchange received from service rendered. This would not be applicable to the Hotel Industry.
4. 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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