ANF 4C

Application for Fixation or Revision of DEPB Rates / Fixation of Brand rate of DEPB for SAD component
[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)	( v )
i. Merchant Exporter
ii. Manufacturer Exporter
iii. Service Provider
iv. Merchant cum Manufacturer
v. Others (please specify)
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 for (please tick) ( v )
i. Fixation of DEPB rate
ii. Fixation of Brand rate for SAD component
iii. Revision of Value Cap

8. Export Product Details for which fixation of rate is sought (In case of revision of existing rate, pl indicate the existing DEPB Entry Sl. No. and the product group separately).
Export Product Group	Description of Item of export	SION Sl.No. in HBP v2	Inputs allowed
			Description	ITC(HS) Code	Basic Customs Duty

9. Total exports effected during preceding three licensing years

Year	FOB value ( in Rupees)

10. Exports made during past one year of the item for which DEPB rate/revision in DEPB rate is applied for.

Item of export	Quantity	FOB value (in Rupees)

11. Details of imports effected during the past 12 months of inputs allowed under Standard Input Output Norms (HBP v2)

Sl. No.	Item(s) of import	Bill of Entry details		Quantity of import (Kg./MT etc.)	CIF value (in Rupees)	Per unit CIF value (in Rupees)
		No.	Date

12. Details of international journals / magazine (if any) evidencing international price of inputs in support of the data furnished above.

13. Worksheet for computation of DEPB Rates:

FOB value (in Rs) per unit quantity of export product (Kg./MTetc.)	Description of import items (including fuel as consumable) allowed as per SION	Quantity of import item allowed for each of the input as per SION (Kg./MT etc.)	CIF value per unit quantity (Kg./MT etc.) of each of the item allowed for import in SION (In Rs. )	CIF value of each of the input allowed for import in SION [Column (3) X Column (4)] (In Rs. )	Rate of basic Customs Duty against each of the input allowed for import in SION
(1)	(2)	(3)	(4)	(5)	(6)
				Total CIF value (In Rs.)

14. In case brand rate of DEPB is sought for the Special Addl. Duty (SAD) component, please furnish:

Export Product	DEPB entry Sl No.	FOB value per unit quantity of export product (Kg./MTetc.)	Description of import items allowed as per SION	Quantity of import item allowed for each of the input as per SION (Kg./MT etc.)	CIF value of each of the input allowed for import in SION (In Rs)	SAD paid as per Bill of Entry (B/L)
						B/L No	B/L Date	Amount paid (in Rs)
								Total value (In Rs.)

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 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

[For DEPB rate fixation, please see paragraph 4.38 of HBP v1; For Brand Rate of DEPB for the SAD component, please see Para 4.3 of FTP]

For fixation / revision of DEPB rate:

1. Five copies of the application along with the supporting documents must be submitted and the application should be routed through the Concerned Export Promotion Council / Commodity Board (certifying the facts and figures as All Industry average) dealing with the export product.

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 been given at the time of obtaining IEC.

4. Application must be accompanied by documents as per details given below:

a. In support of data furnished at serial no. 10,11 & 12 of the Application, minimum 5 Shipping Bills /Bills of Entry (self certified copies) should be submitted for each item of export/ import during the past 12 months. This may however be restricted to two Shipping Bills/Bills of Entry/per month for exports/ imports made during the past 12 months. Alternatively in lieu of the Bills of Entry, the firm may submit copies of Customs data for imports containing the name of the raw materials, quantity, CIF value, name of the importers, port of import etc.

b. International price of items of import as obtained from international journals/ magazines (as given in serial no.12) are to be submitted only in support of actual imports. If the applicant has insufficient data on the items of import/export, he may also submit data and documents of other exporters of the same export product.

c. Though 5 copies of the application should be submitted, only two copies of the supporting documents viz. relevant Shipping Bills/ Bills of Entry etc are to be submitted in support of all the data, as furnished by the applicant.

d. For factoring the Component of Customs duty on the relevant fuel in DEPB rate, only those fuels which have been allowed as “consumable” in the SION shall be considered and not that quantum of fuel, which is meant for power generation. Duty incidence on fuel shall be calculated in the same manner as is being done for other inputs figuring in the SION.

Note: The DEPB rate shall be fixed only for those products for which Standard Input Output Norms have been notified. In case of an export product for which Standard Input Output Norms is not fixed, the applicant has to first apply for fixation of SION.

For fixation of Brand rate of DEPB for SAD component:

For fixation of Brand rate of DEPB for the Special Addl. Duty component, applicant needs to furnish:

1. Two copies of the application along with the copy of relevant Bill of Entry;

2. Applicant need not fill up the columns at Sl No. 8, 9, 10, 11, 12 & 13 of the application;

3. A copy of certificate for non-availment of CENVAT credit as stated in paragraph 4.3 of FTP;

4. Copies of the Shipping bills filed under DEPB scheme along with a statement containing Shipping Bill number, date and the corresponding FOB value of the export product for which the SAD claim has been filed. This statement is to be certified by an Independent Chartered Accountant.