ANF 4D

Application for clubbing of Advance Authorisations

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

1. IEC Number

2. Applicant Details

i. Name

ii. Address

3. Details of Authorisations to be clubbed

Sl. No	Authorisation details		Issued under Customs Notification no. & date	Export product	Port of Registration	Expiry date of initial EO period	Expiry date of extended EO period, if any
	Number	Issuance date

4. Details of physical exports / deemed exports made against each individual Advance Authorisation:

Sl.No.	Products Exported/ Supplied	Shipping Bill/ Invoice/ AR 3 Details		Quantity Exported / Supplied				FOB Value
		No	Date	Physical exports		Deemed Exports	Total	In case of physical exports (as per S/B)	In case of deemed exports (as per invoices)	Actually realized (as per BRC)
				Direct exports	Third Party exports

5. Details of imports allowed and imports actually made against each individual Authorisation:

Sl.No	Item of Import	Imports allowed in the Authorisation		Bill of Entry Details		Imports completed
		Qty allowed	CIF Value allowed ( in FFE)	No	Date	Qty		CIF value utilized (in FFE)
						In absolute terms	In %	In absolute terms	In %

6. Consolidated Details of physical exports / deemed exports made against all Authorisations.

Sl.No.	Products Exported / Supplied	Shipping Bill/ Invoice / AR 3 Details		Quantity Exported / Supplied				FOB Value
		No	Date	Physical exports		Deemed Exports	Total	In case of physical exports (as per S/B)	In case of deemed exports (as per invoices)	Actually realized (as per BRC)
				Direct exports	Third Party exports

7. Consolidated Details of imports allowed and made against all Authorisations

S No	Item of Import	Imports allowed in the Authorisations		Bill of Entry Details		Imports completed
		Qty allowed	CIF Value allowed ( in FFE)	No	Date	Qty		CIF value utilized (in FFE)
					In absolute terms	In %	In absolute terms	In %

8. Details of excess imports made proportionate to the export obligation fulfilled

S No	Item of Import	Bill of Entry Details		Quantity	Duty Details
		No	Date		Customs Duty	Interest	Total

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

[ Pl see paragraph 4.20 of 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. Clubbing of Advance Authorisation with Advance Authorisation for annual requirement not permitted.

4. Application must be accompanied by Advance Authorisation (s) in original.

5. FOB value of export for the purpose of V.A shall be arrived at after excluding the Foreign Agency Commission, if any. This provision shall be applicable for authorizations issued on or after 1.4.2008.

6. Authorisations should have been issued by the same RA.