ANF 4J

Diamond Imprest Application

[Please see guidelines (at the end) before filling the application]

1. IEC Number

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. Total FOB value applied for

i. In Rupees

ii. In Foreign Currency

9. Total CIF value applied for

i. In Rupees

ii. In Foreign Currency

10. Foreign Buyer Details ( in case of application against specific Order)

i. Name

ii. Address

iii. Export Order no

iv. Export Order date

11. Amount of Commission or Discount, if any:

12. Export Performance Details in respect of cut and polished diamonds during the preceding three licensing years:

Licensing Year	Against DTC Licence ( in Rs)	Against Others (in Rs)
1.
2.
3.

13. Details of Outstanding Export Obligation under Diamond / DTC Imprest Authorisation, if any

S No	Authorisation No	Authorisation Date	CIF Value (Rs)	FOB Value (Rs)	%age of EO fulfilled		Expiry Date of EO period
					Qty wise	Value wise

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 4A.26.1 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/EFT details evidencing payment of application fee in terms of Appendix 21B.

b. Self certified copy of Export Order.

c. Statement of exports of cut and polished diamonds made during the preceding three licensing years duly certified by Chartered Accountant/Cost & Works Accountant in the format given in Appendix 26. The value of exports made towards fulfillment of export obligation under Diamond Imprest Authorisation shall be shown separately.

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