APPENDIX 14-I-A

APPLICATION FOR SETTING UP EOU UNITS IN SPECIAL ECONOMIC ZONE

Note:

1. Please see Para 6.3.1 to 6.3.3 of the Chapter 6 of the Handbook of Procedures (Vol.-I).

2. Please read the general instructions given in EOU scheme before filling this application and also some important guidelines given at the end of this application.

3. The application may be sent electronically or otherwise. But the same will be treated as incomplete without its own permanent e-mail and will not be considered.

Indicate Whether The Application Is For
AUTOMATIC APPROVAL	OR	BOARD OF APPROVAL

The application should be submitted to the Development Commissioner of the concerned Special Economic Zone(for setting up EOUs in 3 copies alongwith a crossed Demand Draft of Rs. 5,000/- drawn in favour of the Pay & Accounts Officer, Ministry of Commerce & Industry, Department of Commerce, payable at the Central Bank of India, Udyog Bhavan, New Delhi. (NO FEE SHALL BE CHARGED FOR RENEWAL/ EXTENSION OF LOP/ BROAD BANDING ETC.)

For Official Use only

Application No.	______________________________
Date :	______________________________ Date__________Month____________Year __________
Details of Bank Draft Amount Rs. Draft No. Draft date Drawn on Payable at	____________________ ____________________ ____________________ ____________________ (Name of the Bank) ____________________

I.	NAME AND ADDRESS OF THE UNDERTAKING IN FULL (Block Letters)
	Name of the Applicant Firm	_________________________________
	Full Address	_________________________________
	(Regd.Office in case of limited companies & Head Office for others	_________________________________ _________________________________ _________________________________
	Pin Code	_________________________________
	Tel. No.	_________________________________
	Fax No.	_________________________________
	Permanent E-Mail Address	_________________________________
	Web-Site, if any	_________________________________
	Passport No., if any	_________________________________
	Name of Bank with Address & A/c No.	_________________________________
	Digital Signature	_________________________________
	Income Tax PAN	_________________________________
	The name and address of each Of the Director/Partner	_________________________________
II.	NATURE OF THE APPLICANT FIRM: [Please tick (ü ) the appropriate entry] Government Undertaking/Public Limited Company/Private Limited Company/ Proprietor ship/Partnership/Others (please specify)
Note:-	Copy of certificate of incorporation alongwith Article of Association and Memorandum in case of companies and partnership deed in case of partnership firms may please be attached.
III.	INDICATE WHETHER THIS PROPOSAL IS FOR [Please tick (ü) the appropriate entry].
	Establishment of a New Undertaking - Manufacturing	[ ]
	- Services	[ ]
	Effecting Substantial Expansion Manufacturing of New product Conversion of (i) existing DTA unit into EOU (ii) existing STP/EHTP to EOU (In case of conversion, please attach fact sheet as per Annexure)
IV.	(1) Location of the proposed undertaking Full Address __________________________ Pin code __________________________
(2)	ONLY FOR PROJECTS UNDER EOU SCHEME (In case the unit is proposed to be located on leased premises, then lease should be obtained from Government or any undertaking / authority of Government. However in case lease is obtained from private parties, it shall have a validity period of five years from the date of LUT and the Development Commissioner shall satisfy himself of genuine nature of the lease.)
(a)	Please indicate if the proposed location is in a Centrally Notified Backward Area [Please tick (ü) the appropriate entry]. No. ______________Yes_________________ if yes, indicate category
(b)	Indicate whether it is within 25 Kms from the periphery of the standard urban area limit of city having population above one million according to 1991 census. Yes_____________ No. __________________
(c)	Is it located in an Industrial Area/Estate designated/set up prior to issuance of Notification No. 477(E) dated 25th July,1991. Yes_____________No. _____________
(d)	If not, does it come under the category of non-polluting industries as notified by the Govt. Yes ___________ No. _______________
V.	ITEM (S) OF MANUFACTURE/SERVICE: (Including By-product/Co-products) (If necessary, additional sheets may be attached)

Item(s) Description	Capacity(Unit = )	item Code(ITC HS Code No.) Not required for service unit)
________________	________________	_______________________
________________	________________	_______________________
________________	________________	_______________________

V-A: Intermediate Products, if any, which are to be taken out for job work abroad as part of production process.

Item(s) description	Quantity	Item code(ITC (HS) code No) Not required for service unit
________________	_____________________	__________________
________________	______________________	__________________

VI.	PRODUCTION (In case of more than one item, supplementary sheets may be used)
		Quantity (Unit __________) Not required for service unit)	(Value (In Rupees)
	1st year	___________________	__________________
	2nd year	___________________	__________________
	3rd year	___________________	__________________
	4th year	___________________	__________________
	5th year	___________________	__________________

VII.	Indigenous Requirement:	(Value in Rupees)
a)	Capital Goods
b)	Raw material, components, consumables, packing material, fuel etc. during the period of 5 years
	TOTAL:	------------------------ ------------------------
VIII.	FOB VALUE OF EXPORTS	(1 $ = Rs.)
	Rupees (lakhs)	US $ (Thousand)

1st year
2nd year
3rd year
4th year
5th year
Total:

IX.	INVESTMENT:	(RS. IN LAKHS)
(a)	Land	________________________
(b)	Building	________________________
(c)	Plant and Machinery	________________________
	(I) Indigenous	________________________ (US $ Thousand)
	(ii) Import CIF value	________________________
	(iii) Total (I) + ii)	________________________
(d)	Details of source(s) of finance, (both Indian as well as foreign) for the above investments

X.	WHETHER FOREIGN TECHNOLOGY AGREEMENT IS ENVISAGED (Please tick ( ü ) the appropriate entry )
	Yes ____________	No_____________
	(I) Name and Address of foreign collaborator	____________________
	(ii) Terms of collaboration	(Rupees lakhs) (Gross of Taxes)
	(a) Lumpsum payment	_____________________
	(b) Design & Drawing fee	_____________________
	(c) Payment to foreign technician	_____________________
	(d) Royalty (on exports)	____________________%
	(e) Royalty (on DTA sales if envisaged)	____________________
	(f) Duration of agreement	________________(No.of years)

XI.	EQUITY INCLUDING FOREIGN INVESTMENT
(i)		$ Thousand)	(Rs.lakhs)
	(a) Authorized	________________	________________
	(b) Subscribed	________________	________________
	(c) Paid up Capital	________________	________________
Note: If it is an existing company, please give the break up of the existing and proposed capital structure
(ii)	Pattern of share holding in the paid-up capital (Amount in Rupees)
		(Rs. in lakhs)	(US $ Thousand)
(a)	Foreign holding	_____________	___________________
(b)	Non Resident Indian company / Individual holding
	(i) Repatriable	_____________	___________________
	(ii) Non-repatriable	_____________	___________________
(c)	Resident holding	_____________	___________________
(d)	Total (a+b (i+ii)+c) equity	_____________	___________________
(e)	(iii) External commercial Borrowing	______________	____________________

Foreign Exchange Balance sheet

		1st	2nd	3rd	4th	5th	Total (5 yrs) In Rs. Lakhs	Total In Th US$
XII.	FOB value of exports in first five years
XIII.	Foreign Exchange outgo on
(I)	Import of machinery
(ii)	Import of raw materials and components
(iii)	Import of spares and consumables
(iv)	Repatriation of dividends and profits to foreign collaborators
(v)	Royalty
(vi)	Lump sum know-how fee
(vii)	Design and drawing fee
(viiii)	Payment of foreign technicians
(ix)	Payment on training of Indian technicians abroad
(x)	Commission on Export etc.
(xi)	Foreign Travel
(xii)	Amount of interest to be paid on external commercial borrowing/deferred payment credit(specify details)
(xiii)	Any other payments(specify details)
	Total (i)to(xiii)
	Net Foreign Exchange earnings in five years

XIV.	REJECTS (Only for EOU manufacturing units.)
	Generation of Rejects/Sub-standard finished goods	__________ __________	__________________ __________________ (percentage of 5 yrs production)
	Goods (In case rejects are more than 5% estimated percentage with justification may be given	__________________ ________________ Value (Rs. Lacs)	(Qty.(Unit = ) __________________ ________________
XV.	EMPLOYMENT		(All figures in number)
	Existing --------------		Proposed --------------
	a) Supervisory	Men_______________ `Women_____________	_______________ _______________
	b) Non-supervisory	Men_______________ Women_____________	_______________ _______________
XVI.	Net Foreign Exchange Earning Average NFE on FOB value of exports in block period, as per para 6.5 of FTP	_________	_________
[OLD- XVI.	NET FOREIGN EXCHANGE EARNING Average NFE on FOB value of exports in 5 years	_________	_________]
XVII.	MARKETING
	a) Whether marketing tie-up/Buy-back envisaged/finalized (Attach documents, if any)	_______ _______ Yes	________ ________ No
	b) Destination of exports (in percentage)	G. C. A. _______ _______	R. P. A. ________ ________
XVIII	OTHER INFORMATION
	i) Any special features of the project proposal which you want to highlight		_________________ _________________
	(please attach the project report, for new units) (Above entry against XVI has been substituted vide PN. NO. 53/2008, DT. 23/07/2008)
			_______________________ _______________________ _______________________
	ii)(a) Whether the applicant has been issued any Industrial license or LOI/LOP under EOU/STP/EHTP scheme if so, please give full particulars especially reference number, date of issue, items of manufacture and progress of implementation of each project.		_________________ _________________ _________________
	(b) Whether the applicant has submitted any other application for LOI/LOP which is pending with the Board of Approvals. If so, please give particulars like reference number, name under which application made, items of manufacture etc.		__________________ __________________
	iii) Whether the applicant or any of the partners/Directors who are also partners /Directors of another company or its associate concerns are being proceeded against or have been debarred from getting any License/Letter of Intent/ Letter of Permission under the Export and Import (Control) Act. 1947/Foreign Trade (Development and Regulation) Act, 1992 / FEMA/ Custom/Central Excise Act.		_________________ _________________

Place :_________ Date :________ Official Seal/Stamp_________________	Signature of the Applicant	____________________
	Name in Block Letters	__________________
	Designation	___________________
	Tel. No.	___________________
	e-mail	___________________
	Web-Site, if any	___________________
	Full Residential Address	_________________

UNDERTAKING

I/We hereby declare that the above statements are true and correct to the best of my/our knowledge and belief. I/We will abide by any other condition, which may be stipulated by the concerned Development Commissioner. I/We fully understand that any Permission Letter granted to me/us on the basis of the statement furnished is liable to cancellation or any other action that may be taken having regard to the circumstances of the case if it is found that any of the statements or facts therein are incorrect or false. An affidavit duly sworn in support of the above information is enclosed.

Place:__________	Signature of the Applicant	_________________
Date:___________	Name in Block Letters Designation	_________________ _________________
Official Seal/Stamp	Full Official address	_________________ _________________ __________________
	Tel. No. e-mail Address Web-Site Full Residential address Tel. No	_________________ _________________ _________________ __________________ __________________ __________________

SOME IMPORTANT GUIDELINES

1. Additional Information may be furnished by existing domestic units seeking conversion into the EOU Scheme as per annexure.

2. Normally raw material tie-ups are not insisted upon but this may be necessary in cases, such as granite/marble/sandstone products where availability of raw materials is contingent upon Government leases etc.

3. Normally lumpsum amount up to US $ 2 Million and 8% royalty (net of taxes) as amended from time to time over a period of five years from the commencement of production is allowed as per the current EOU Scheme on account of foreign technology agreement as per the norms of Department of Industrial Policy and Promotion. In addition selling agency commission is permitted as per RBI norms.

4. Cases involving high outgo of foreign exchange for capital goods and raw materials, the Government prefers raising of funds through external commercial borrowings.

ANNEXURE

PROFORMA TO BE FILLED IN BY THE EXISTING DTA UNITS SEEKING CONVERSION INTO THE EOU SCHEME

a)	Whether conversion of DTA Unit into the EOU has been sought for the full existing capacity of the unit or the proposal is for partial conversion.(Please give details of the existing capacity etc.)
b)	Whether any expansion of the DTA unit proposed to be converted into EOU has bee envisaged, if so the extent thereof.(Please give details of the existing capacity and the enhanced capacity etc).
c)	What is the level of existing exports of the unit proposed to be converted into EOU. (Please give details of export performance item-wise for a minimum of three previous years)
d)	Whether the DTA unit is already under obligation to export, under: i) Advance Licensing Scheme; ii) Import of machinery under EPCG scheme; iii) Any other Scheme. (Give all relevant details including total E.O. imposed, the E.O. discharged till date etc.)
e)	Whether your unit is registered with the Customs or Excise authorities. (Please give details viz. Reg. No., date etc.)
f)	Are you agreeable to have your whole unit customs bonded as required under the EOU scheme?
g)	Whether you are a merchant exporter or a manufacturer exporter.(Please give details)
h)	What is the age(year of manufacture)and residual life of items/ machinery already installed in your unit, whether they are imported or indigenous.(Please attach separate sheets giving item-wise details with value of the new CG as well as existing value of machinery presently installed).

Date____________	Signature________________________ Name __________________________
Place __________	Address of the Applicant ____________