APPENDIX - 9

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APPLICATION FORM FOR GRANT OF LICENCES FOR CAPITAL GOODS INCLUDING COMPUTER, COMPUTER SUB-SYSTEMS AND SERVICE EQUIPMENT UNDER THE EPCG SCHEME

Note:

1. Please see Paragraph 5.2 of this Handbook.

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

3. Please submit 2 copies of this application form.

File No	Date

1. Name and address of the applicant	: M/S
2. IEC Number	:
3. Please tick the appropriate column.
(i) Manufacturer Exporter	:
(ii) Merchant Exporter	:
(iii) Service Provider (please specify as per Appendix 36)	:
4. i) Name of the applicant or his supporting manufacturer(s)/ vendor(s) SSI/ IEM No Dated Issuing Authority ii) Address of the factory/premises where the capital goods to be imported are proposed to be installed iii) Address of the jurisdictional Central Excise Authority under whom the proposed CG is to be installed iv) The manufacturing products endorsed on SSI/ Industrial Licence / IEM
v) Whether any export obligation has been imposed in the Letter of Intent/ Industrial Licence/ FC Approval If yes, give details thereof including E.O. fulfilled, if any	:Yes/ No
5. Port of Registration	:
6. (i) Name of the end products to which the proposed Capital Goods are related (ii) whether related in the pre production/ production / post production activity (please specify) (iii) Product(s) to be exported
7. Category of service provider ------------------- (If applicable) Regd.No. --------------------- Dated ---------------------- Issuing authority -----------------
8. Details of capital goods applied for import: (Tick the appropriate column)
(a) Capital goods/ jigs, fixtures, dies and moulds/ spares	[ ]
(b) New spares for old capital goods/ machinery	[ ]

S.No	Description and technical specification of the items of import	Quantity	CIF value in freely convertible currency
(1)	(2)	(3)	(4)

9. Details of duty levied/ saved:

*Total effective basic Customs duty, additional Customs duty, education cess on items to be imported/deemed to be imported (in %)	Duty to be levied under EPCG scheme (in %age)	Duty saved (in %)	CIF value of imports/deemed imports (in equivalent rupees Rs.)	Duty Saved (in Rs.)
(1)	(2)	(3) = (1)-(2)	(4)	(5)= (3)*(4)/100
	5% or 0% (in case of agro products)

*Note: In case of EPCG Licence for Projects as per para 5.1B of Policy, the basic customs duty would be 10%. Wherever, CVD is paid in cash and not subsequently CENVATed, CVD would not be taken for computation of net duty saved.

10. (i) Duty saved on the imports / deemed imports (As per column 5 in the table above) (in Rupees)	:
(ii) Export Obligation (In Rupees)	:
(iii) Export Obligation (in freely convertible currency)	:

11. Details of exports made for the same on similar export product during preceding three licensing years.

LICENSING YEAR	FOB VALUE OF EXPORTS (in Rupees)	PRODUCTS EXPORTED
[1]	[2]	[3]

12. Details of EPCG Licences already obtained which have not been redeemed:

S.No.	Licence No. and date	CIF value (In Rupees)	Export obligation fixed in freely convertible currency	Whether BG/ LUT executed	%age of export obligation fulfilled
(1)	(2)	(3)	(4)	(5)	(6)

13. Details of Fee Paid

:

Bank Receipt DD/TR No.& date Amount (Rs.) Name of the Bank Branch of issue

DECLARATION/UNDERTAKING

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I/We hereby solemnly undertake/declare that:-

(i) 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.

(ii) I/We full 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.

(iii) 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.

(iv) That I/We shall be liable to penal action in accordance with the Policy/Procedure/Foreign Trade (Development & Regulation) Act, 1992 the Rules and Orders framed thereunder and the Customs Act, 1962 addition to forfeiture of Bank Guarantee or any other Bond/Guarantee given to the Customs/licensing authority, in the event of failure to fulfill the export obligation as stipulated, within the export obligation period prescribed or subsequently extended by the competent authority.

(v) 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.

(vi) I hereby certify that I am authorized to verify and sign this declaration as per paragraph 9.9 of the policy.

(vii) I hereby declare that the capital goods/spares sought for import in the application are actually required for use at pre production/ production/post production stages of the products or provide the services indicated in the application for fulfilment of export obligation. I undertake to refund the custom duty as applicable with 15% interest on the goods imported & found having no relation with product exported or service provided as per Policy provision of Para 5.4 of Foreign Trade Policy, at any stage.

(viii) I/We hereby declare that in respect of imported goods for which nexus is not established and found having no relation with the product exported or service rendered, I/We shall pay to the Government Customs duty saved together with 15% interest on such goods at any stage.

Signature of the Applicant: ____________________________
Name: ____________________________
Designation: ____________________________
Official Address: ____________________________
Residential Address : ____________________________
E-mail address: ____________________________

Place : _______________
Date : _______________



Documents to be enclosed with the application form

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1. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-29.

2. Manufacturers illustrated pamphlets/catalogue/drawing/technical design etc.

3. Statement of exports achieved by the applicant in respect of the same/similar export product/services rendered during the preceding three licensing years duly certified by a Chartered Accountant/Cost and Works Accountant in the form given in Appendix- 23/23A.

4. Registration Certificate with the Service Tax Authorities. However this is applicable only for service providers.

5. A Chartered Engineer Certificate (two copies) certifying :-

(i) The end use of machinery sought for import under EPCG Scheme for which the proposed Capital Goods are related in the pre production/production/post production activity (explaining the end use of machinery in detail);

and/or
(ii) The essentiality of spare parts sought for import and its required quantity for existing machinery manufacturing the goods to be exported/ machinery sought for import;

and/or
(iii) The complete usage of equipments/goods sought for import under the EPCG Scheme for supply of service to overseas customers/ service consumers of any other country in India to earn free foreign exchange/supply of service in India relating to export paid in free foreign exchange.

6. Copy of Drug Manufacturing License in case of export of Pharmaceutical product or copy of IEM/SSI Registration Number in case of other products. (P N 26: dtd. 30/09/03)

7. Address of the jurisdictional Central Excise Authority under whom the proposed CG is to be installed may not be insisted in the case of Service Providers who are not registered with Service Tax authorities. A declaration from the applicant may be taken in this regard.

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Annexure-I to Appendix-9

(To be furnished on the letterhead of the Chartered Engineer)

Chartered Engineer Certificate For Certifying End Use Of Capital Goods To Be Imported In Regards To Pre-Production/ Production/ Post Production Activity Of The Firm Vis-À-Vis Exports Under The EPCG Scheme

I have examined the applicant firm’s/company’s import requirement for the capital goods w.r.t their nexus with the pre production/production/post production activity undertaken by the firm/company mentioned in Col.4 of Appendix 9 and with reference to their endorsement in SSI/Industrial Licence/IEM. I hereby certify that the capital goods proposed to be imported by the licensee M/s. __________________________ under EPCG scheme is required for use at pre-production/production/ post production stage as per the details given below:-

1. Name/Model Number/Technical Specifications of the Capital Good (s)	:
2. Quantity required with justification thereof	:
3. Export products to which CG related	:
4. End use of CG for export product and the stage where and how to be used (Additional sheet, if required, may be attached)	:
5. Stepwise process/flow chart	:

Signature & Seal of Chartered Engineer
Alongwith Registration Number

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(Appendix - 9 has been amended vide P.N. No.22/2004, DT. 08/11/2004)

[OLD-
APPENDIX - 9

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APPLICATION FORM FOR GRANT OF LICENCES FOR CAPITAL GOODS INCLUDING COMPUTER, COMPUTER SUB-SYSTEMS AND SERVICE EQUIPMENT UNDER THE EPCG SCHEME

---

Note:

1. Please see paragraph 5.2 of this Handbook.

2. Please read the general instructions 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 of the applicant	: M/s............................. ...................................
2.	IEC Number	:
3.	Please tick the appropriate column.
	(i) Manufacturer Exporter	:
	(ii) Merchant Exporter	:
	(iii) Service Provider (please specify as per Appendix-36	:
4.	i) Name of the applicant or his supporting manufac-turer(s)/vendor(s). SSI/IEM NO. Dated Issuing Authority	................................................ ................................................ ................................................ ................................................ ................................................ ................................................
	ii) Address of factory where the capital goods to be imported are proposed to be installed	................................................ ................................................ ................................................
	iii) The manufacturing products endorsed on SSI/Industrial Licence/IEM.	................................................ ................................................ ................................................
	iv) Whether any export obligation has been imposed in the Letter of Intent/ Industrial Licence/ FC Approval. If yes, give details thereof including E.O fulfilled, if any:	: Yes/No.
5.	Port of registration	: .........................
6.	(i) Name of the end products to be manufactured out of the proposed capital goods.	: .............................
	(ii) Product(s) to be exported	: .............................
7.	Category of service provider (If applicable) Regd.No. ................... Dated ................... Issuing authority ...................	: [ ]
8.	Details of capital goods applied for import: (Tick the appropriate column) (a) Capital goods /jigs, fixtures, dies and moulds /spares [ ] (b) New spares for old capital goods /machinery [ ]

S.No.	Description and technical specification of the items of import	Quantity	CIF value in freely convertible currency
(1)	(2)	(3)	(4)

9. Details of duty levied/ saved:

*Total effective basic Customs duty, additional Customs duty, education cess on items to be imported/deemed to be imported(in %)	Duty to be levied under EPCG scheme (in %age)	Duty saved (in %)	CIF value of imports/deemed imports (in equivalent rupees Rs.)	Duty Saved (in Rs.)
(1)	(2)	(3) = (1)-(2)	(4)	(5) = (3)* (4)/1 00
	5% or 0% (in case of agro products)

(Above S. No. 9. has been amended vide PN. No. 8/2003, Dt. 14/05/2003)

*Note: In case of EPCG Licence for Projects as per para 5.1B of Policy, the basic customs duty would be 10%. Wherever, CVD is paid in cash and not subsequently CENVATed, CVD would not be taken for computation of net duty saved.

10.	(i) Duty saved on the imports / deemed imports (as per column 5 in the table above	:(In Rupees)................................
	(ii) Export obligation (in freely convertible currency)	:(In Rupees)...................................

11. Details of exports made for the same on similar export product during preceding three licensing years.

LICENSING YEAR	FOB VALUE OF EXPORTS (in Rupees)	PRODUCTS EXPORTED
[1]	[2]	[3]

12. Details of EPCG Licences already obtained which have not been redeemed:

S.No.	Licence No. and date	CIF value (In Rupees)	Export obligation fixed in freely convertible currency	Whether BG/LUT executed	%age of export obligation fulfilled
(1)	(2)	(3)	(4)	(5)	(6)

13.

Details of Fee

: Bank receipt/ ..................... DD No.& date:...................... Amount Rs. ........................ Name of the Bank and Branch of issue ...................

DECLARATION/UNDERTAKING

I/We hereby solemnly undertake/declare that:-


(i) 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.

(ii) I/We full 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.

(iii) 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.

(iv) That I/We shall be liable to penal action in accordance with the Policy/Procedure/Foreign Trade (Development & Regulation) Act, 1992 the Rules and Orders framed thereunder and the Customs Act, 1962 addition to forfeiture of Bank Guarantee or any other Bond/Guarantee given to the Customs/licensing authority, in the event of failure to fulfill the export obligation as stipulated, within the export obligation period prescribed or subsequently extended by the competent authority.

(v) 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.

(vi) I hereby certify that I am authorised to verify and sign this declaration as per paragraph 9.9 of the policy.

(vii) I hereby declare that the capital goods/spares sought for import in the application are actually required for use to produce/support the production of the goods or provide the services indicated in the application for fulfilment of export obligation. I undertake to refund the custom duty as applicable with 15% interest on the goods imported & found having no nexus with export product as per Policy provision of para 5.4 of Exim Policy, at any stage.


I/We hereby declare that in respect of goods for which nexus is not established, we shall pay to the Government Customs duty saved together with 15% interest on such products”

(PN. No. 8/2003, Dt. 14/05/2003)

(PN. NO. 53(RE-03), DT. 27/02/2004)

Signature of the Applicant:	____________________________
Name:	____________________________
Designation:	____________________________
Official Address:	____________________________ ____________________________ ____________________________
Place : _______________ Date : _______________
Residential Address :	____________________________ ____________________________ ____________________________
E-mail address:	____________________________

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Documents to be enclosed with the application form:

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1. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-29.

2. Manufacturers illustrated pamphlets/catalogue/drawing/technical design etc.

3. Statement of exports achieved by the applicant in respect of the same/similar export product/services rendered during the preceding three licensing years duly certified by a Chartered Accountant/Cost and Works Accountant in the form given in Appendix- 23/23A.

4. Registration Certificate with the Service Tax Authorities. However this is applicable only for service providers.

5. A Chartered Engineer Certificate certifying :-

(i) End use of machinery sought for import under EPCG Scheme for manufacture of the product undertaken for Export Obligation (explaining the end use of machinery in detail);

and/or

(ii) The essentiality of spare parts sought for import and its required quantity for existing machinery manufacturing the goods to be exported/ machinery sought for import;

and/or

(iii) Complete usage of equipments/goods sought for import under the EPCG Scheme for supply of service to overseas customers/ service consumers of any other country in India to earn free foreign exchange/supply of service in India relating to export paid in free foreign exchange.

6. Copy of Drug Manufacturing License in case of export of Pharmaceutical product or copy of IEM/SSI Registration Number in case of other products.

(PN. No. 26/2003, DT. 30/09/2003)

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Annexure-I to Appendix-9

(To be furnished on the letterhead of the Chartered Engineer)

CHARTERED ENGINEER CERTIFICATE FOR CERTIFYING NEXUS OF IMPORT OF CAPITAL GOODS VIS-À-VIS EXPORTS UNDER THE EPCG SCHEME

I have examined the applicant firm’s/company’s import requirement for the capital goods w.r.t their nexus with the export product undertaken by the firm/company mentioned in Col.4 of Appendix 9 and with reference to their endorsement in SSI/Industrial Licence/IEM, having regard to proper use of the machine for the product to be exported, I hereby certify that the capital goods proposed to be imported by the licensee M/s. __________________________ under EPCG scheme is required for the Export products at pre-production/production/ post production stage as per the details given below:-

Name of the capital good (s)	:
Quantity required with justification thereof	:
Export products to be produced	:
End use of CG for export product and the stage where and how to be used (Additional sheet, if required, may be attached)	:
Stepwise process/flow chart	:

Signature & Seal of Chartered Engineer
Alongwith Registration Number

(Above Annexure 1 has been added vide PN NO. 57/2003, Dt. 31/03/2004)

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