APPENDIX 14-I-A

APPLICATION FOR SETTING UP EOU/SEZs or UNITS IN SPECIAL ECONOMIC ZONE
Note:

1. Please see Para 6.3.1 to 6.3.3 of the Chapter 6 & Para 7.7.2 to 7.7.4 of Chapter 7 of the Handbook of Procedures (Vol.-I).

2. Please read the general instructions given in EOU/SEZ 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.

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

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The application should be submitted to the Development Commissioner of the concerned Special Economic Zone(for setting up EOUs/units in SEZ) 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 RENEWEL/ EXTENSION OF LOP/ BROAD BANDING ETC.)

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	For Official Use only
Application No.	______________________________
Date :	______________________________
	Date__________Month____________Year __________

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Details of Bank Draft
Amount Rs.	___________________
Draft No.	___________________
Draft date	___________________
Drawn on	___________________ (Name of the Bank)
Payable at	____________________
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/SEZ

(ii) existing STP/EHTP to EOU/SEZ

(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 (v) 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 = )	tem 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		(Qty.(Unit = )
	__________________	________________
	__________________	________________ Value (Rs. Lacs)

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 5 years

_________

_________

XVII. MARKETING

a) Whether marketing tie-up/Buy-back envisaged/finalized (Attach documents, if any)	_______ _______ Yes G. C. A.	________ ________ No R. P. A.
b) Destination of exports (in percentage)	_______ ________	_______ ________

XVIII OTHER INFORMATION

i)	Any special features of the project proposal which you want to highlight	_________________ _________________
(please attach the project report, for new units)
		____________________ ____________________ ____________________
ii)(a)	Whether the applicant has been issued any Industrial license or LOI/LOP under EOU/SEZ/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 :_________	Signature of the Applicant ____________________
Date :________	Name in Block Letters __________________ Designation ___________________
Official Seal/Stamp_________________	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/SEZ 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/SEZ 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/SEZ SCHEME

a)	Whether conversion of DTA Unit into the EOU/SEZ 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/SEZ 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/SEZ. (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/SEZ 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 ____________

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