APPENDIX-10I

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APPLICATION FORM FOR ADVANCE LICENCE FOR ANNUAL REQUIREMENT

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1. Please see paragraph 4.1.7A of the Policy and Paragraph 4.24A of this Handbook.

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

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FOR OFFICIAL USE

File Number:----------------------------

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

1.	Name and address of the applicant	: .......................
2.	I.E. Code No.	: .......................
3.	Name and address of factory of the manufacturer/ supporting/co-manufacturer:	: .......................

b) Type of unit	Registration number	Date

4.	Total FOB value of exports including commission:	Rs. ........ in currency .... in US $ ................ of exports
5.	Total CIF value of imports:	Rs. ........ in currency .... in US $.................of exports

6.	Application fee:	a) Bank Receipt/D.D No.and date. ................
		b) Issued by : .................................
		c) Rupees : .................................

7.	Port of Registration:	................................
8.	Major Export Product Group	................................
9.	FOB value of exports in preceding Licensing year	: ...............................
10.	CIF value of Advance Licence for Annual Requirement applied for	: ...............................
11.	CIF value of Advance Licence for Annual Requirement already obtained	: ............................... ...........................

12. Details of Advance Licence/ Advance Licence for Annual Requirement where export obligation is pending:

S.No.	Licences no. and date	CIF value (Rs.)	FOB value (Rs.)	Percentage of export obligation fulfilled		Expiry date of export obligation period
				Quantity wise	Value wise
(1)	(2)	(3)	(4)	(5)	(6)	(7)

DECLARATION/UNDERTAKING

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1. 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.

2. I/We fully 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.

3. 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.

4. 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.

5. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 3.8 of the Policy.

6. I/We hereby declare that we shall only import inputs required for export production and no part of it shall be sold/transferred/disposed off or utilised in any manner except for utilisation in discharge of export obligation

7. I/We further declare that before exporting a product for which Standard Input Output Norms is not fixed, I shall furnish an application in Appendix-10A to the DGFT, Udyog Bhavan, New Delhi. I further agree to abide by the norms so fixed by DGFT.

Signature of the Applicant: ......................................
Name: ......................................
Designation: ......................................
Official address: ......................................
Tele No: ......................................
Residential address: ......................................
E-Mail : ......................................

Place: ......................................
Date: ......................................

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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-34.

2. CA certifying the preceding year export in the format given in Appendix-26.

3. Copy of manufacturing licence of the applicant or his supporting manufacturer.

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