APPENDIX 23

REGISTER FOR ACCOUNTING THE CONSUMPTION AND STOCKS OF DUTY FREE IMPORTED OR DOMESTICALLY PROCURRED RAW MATERIALS, COMPONENTS ETC. ALLOWED UNDER ADVANCE AUTHORISATION / DFIA*
(Please read paragraph 4.26 and 4.30 of the Handbook, Vol. 1)

INPUTS ALLOWED IN THE AUTHORISATION (S) (A NO. OF AUTHORISATIONS*** CAN BE CLUBBED TOGETHER FOR THE PURPOSE OF ACOUNTING OF INPUTS)				PRODUCT (S) EXPORTED UNDER THE AUTHORISATION (S)				EXCESS INPUTS, IF ANY,ALLOWED UNDER THE AUTHORISATION(S). (4 - 8)	IN CASE OF EXCESS AS IN COLUMN 9			REMARKS
Sl No.	Authorisation No(s) with date (A No. of authorisations can be clubbed together for accounting purpose)	Inputs	Quantity	Product	Quantity	Inputs Actually consumed for the exported product			Additional exports effected in proportion to excess inputs	Input quantity reduced proportiona-tely in the authorisation**	Customs duty paid alongwith interest
						Inputs	Quantity (Including actual wastage incurred)
1	2	3	4	5	6	7	8	9	10	11	12	13

* In case of post export replenishment, details of inputs used (whether duty paid or not) in the exported product has to be furnished.

**Applicable only in case either partial import or “NIL” import has been effected.

*** In case of transferable DFIA, information in the above format has to be furnished individual DFIA wise.

We declare that the aforesaid particulars are correct.

Place: Date: Official Seal/stamp	Signature of the authorisation holder	: ........................................
	Name in block letters	: ........................................ : ........................................
	Designation	: ........................................
	Full official address	: ........................................
	Full Residential address	: ........................................

Appendix 23 Continued

CHARTERED ACCOUNTANT / COST & WORKS ACCOUNTANT CERTIFICATE

I/We hereby confirm that I / We have examined the prescribed registers and also the relevant records of M/s..........................……………………………………………having IEC number……………………... and PAN number…………………….for the licensing period(s) ………………………………and hereby certify that the information furnished above is true and correct in all respects; no part of it is false or misleading and no relevant information has been concealed or withheld;

I / We fully understand that any statement made in this certificate, if proved incorrect or false, will render me / us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.

I/We further declare that neither I, nor any of my / our partners is a partner, director, or an employee of the above-named entity, its Group companies or its associated concerns.

(Signature and Stamp/ Seal of the Signatory)
(Chartered Accountant/ Cost & Works Accountant)

Place: Date:

Name of the Signatory: Address: Membership No:

Note:

1. Each page of this document is to be signed by the Chartered Accountant / Cost and Work Accountant with his registration number.

2. Mention N.A. wherever the information required in the table is not applicable.

3. For columns 10, 11 & 12 of the table, please furnish the copy of the documentary evidence.

4. The authorisation holder is required to furnish the details for the authorisations which have been redeemed in the last licensing year.