ANF 4I
GEM REP Application
[Please see guidelines (given at the end) before filling the application]
| 2. Applicant Details |
| i. Name |
| ii. Address |
| 3. RCMC Details |
| i. RCMC Number |
| ii. Date of Issue |
| iii. Issuing Authority |
| iv. valid upto |
| Products for which registered |
| 4. Type of Exporter (please tick) | (ü ) |
| i. Merchant Exporter | |
| ii. Manufacturer Exporter | |
| iii. Service Provider | |
| iv. Others (please specify) | |
| v. Merchant cum Manufacturer |
| 5. Industrial Registration Details |
| i. SSI / IEM / LOI or IL Registration Number |
| ii. Date of Issue |
| iii. Issuing Authority |
| iv. Products for which registered |
| 6. Excise Details (For those registered with Central Excise Authority) |
| i. Excise Registration Number |
| ii. Issuing Authority |
| 7. Application Fee Details |
| Amount (Rs) |
| Demand Draft / Bank Receipt / Electronic Fund Transfer No |
| Date of Issue |
| Name of the Bank on which drawn |
| Bank Branch on which drawn |
| 8. Export Proceeds Realisation Month: |
| 9. FOB Value of Exports |
| i. In free foreign exchange |
| ii. In Rupees |
| 10. Value of Authorisation Claimed |
| i. In free foreign exchange |
| ii. In Rupees |
| 11. Details of exports made |
| Name of the Bank | Shipping Bill/ Postal Receipt | FOB Value ( in FFE / Rs ) | FOB Value realised ( in FFE / Rs ) | REP Authorisation Claimed ( Rs ) | Country of Exports |
| | Number | Date | | | | |
| | | | | | | |
| | | | | | | |
Note: In case application for REP Authorisation is made under Para 4A.28 of this handbook, serial no 11 may be left blank
DECLARATION / UNDERTAKING
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 there from. If found incorrect or false, it will render me / us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.
2. I/We undertake to abide by the provisions of FT(D&R) Act, the Rules and Orders framed there under, the FTP, HBP v1, HBP v2 and the ITC(HS) Classification of Export & Import Items.
3. I / We hereby certify that none of the Proprietor / Partner(s) / Director(s) / Karta / Trustee of the firm / company, as the case may be, is / are a Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / Company which has come to the adverse notice of DGFT.
4. I/We hereby certify that the Proprietor / Partner(s) / Director(s) / Karta / Trustee, as the case may be, of the firm/company is / are not associated as Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm/company which is in the caution list of RBI.
5. I / We hereby declare that I / we have perused the list of SCOMET items as contained in the Appendix 3 to the Schedule 2 of the ITC (HS) Classifications of Export-Import Items, 2004-09 and that the item(s) exported / proposed to be exported does not fall within this list and that I / We agree to abide by the provisions of the Policy for export of SCOMET items contained in the Foreign Trade Policy, Schedule 2 of ITC (HS) and the HBP v1, irrespective of the scheme under which the item is exported / proposed to be exported (the underlined portion will be deleted in case an application for export license for SCOMET item is being filed).
6. I / We hereby declare that no export proceeds are outstanding beyond the prescribed period as laid down by RBI or such extended period for which RBI permission has been obtained.
7. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the FTP.
Signature of the Applicant
Name
Designation
Official Address
Telephone
Residential Address
Email Address
| Place
Date |
GUIDELINES FOR APPLICANTS
[ Please see paragraph 4 A.1 and 4A.28 of HBP v1 ]
1. Two copies of the application must be submitted unless otherwise mentioned.
2. Each individual page of the application has to be signed by the applicant.
3. RCMC details need not be given if the same has already given at the time obtaining IEC.
4. Application must be accompanied by documents as per details given below:
a. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix 21B.
b. Bank certificate of export and realisation in the format given in Appendix 22A evidencing realisation of exports proceeds/sales proceeds.
c. Export Promotion (EP) copy of Shipping Bill(s) in Original. (Photocopy of the EP copy of Shipping Bill duly endorsed may be returned for utilization/re-import purposes when the exports are made on consignment basis).
d. Customs attested invoice.
e. In case of application for Replenishment Authorisation under paragraph 4A.28 of this Handbook, an applicant will be required to submit documents as given at S.No.1 above and Statement of Exports made during the preceding licensing year duly certified by Chartered Accountant / Cost & Works Accountant in the format given in Appendix 26.
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