Eximkey India DGFT, Customs, Excise, Export Import policy, Foreign Trade Policy and export import data.

DGFT Hand Book of Procedures Forms & Appendix (Notified vide PN No.06 DT.20/06/2012) ANF 3B

ANF 3B

Application Form for Served From India Scheme (SFIS)

[For Foreign Exchange Earned with effect from 1.1.2011 as per Appendix 41 of HBPv1/ Foreign exchange earned upto 31.12.2010 as per Appendix 10 of HBPv1, as applicable]

Part A

1. Applicant Detail
IEC Number		Branch Code
Name
Address
Telephone No
Email ID
2. Application Details
Application For
Ecom. Reference No		Submission Date
Submitted To
RLA File No		RLA File Date

3. RCMC Details
i. RCMC Number
ii. Date of Issue
iii. Issuing Authority
iv. valid upto
v. Products/Services for which registered

4. Type of Exporter (please tick) ( √ )

i. Government Undertaking

ii. Public Limited

iii. Private Limited

iv. Proprietorship

v. Partnership

vi. Others

5. Nature of Concern (please tick) ( √ )

i. Merchant Exporter

ii. Manufacturer Exporter

iii. Service Provider

iv. Others (please specify)

v. Merchant cum Manufacturer

Part B

6.	Category of Service Provider (Please specify from Appendix 10 / Appendix 41, as applicable)
7.	Frequency of Application [please tick the relevant option]	Monthly
		Quarterly
		Half Yearly
		Annually
Note: Applicants are to exercise the option of applying on Monthly / Quarterly / Half Yearly / Annual basis along with the first application for the current financial year, and this frequency cannot be changed for application made on the basis of Foreign Exchange earnings of the current financial year.
8.	Foreign Exchange Earned for rendering of Service From India to outside India or in India – as per frequency of application:
8.	Supply of Service by Service Provider	Free Foreign Exchange	Equivalent Indian Rupees
i.	Supply of a ‘service’ from India to any other country under Para 9.53 (i) of FTP.
ii.	Supply of a ‘service’ from India to service consumer of any other country in India under Para 9.53(ii) of FTP.
iii.	Supply of a ‘service’ from India through commercial or physical presence in territory of any other country under Para 9.53(iii) of FTP.
iv.	Supply of a ‘service’ in India relating to exports paid in free foreign exchange or in Indian Rupees which are otherwise considered as having being paid for in free foreign exchange by RBI, under Para 9.53(iv) of FTP
Total (Rs)
Entitlement = 10% of Total (Rs)
9.	Port of Registration (for purpose of imports):
10.	Number of Split Certificates required (in multiples of Rs.5 lakhs each)

DECLARATION / UNDERTAKING

1. I / We hereby certify that:

(i) that particulars and statements made in this application are true and correct and nothing has been concealed or held therefrom. I/We fully understand that any information furnished in the application if found incorrect or false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.

(ii) that under Foreign Trade (Development and Regulation) Act (FTDR Act) 1992, my/our firm / company have not been debarred from undertaking any export import business or activity by way of suspension or cancellation of IEC number.

(iii) that my/our firm / company has not defaulted from export obligation under any provisions of FTP and has not been placed under the Denied Entity List (DEL).

(iv) that foreign exchange earned on account of services rendered from India alone in terms of Para 9.53 of FTP has been taken into account for this application under SFIS as per Para 3.12 of FTP 2009-14 and these do not fall under any category or service which are not eligible as per Para 3.6.1 of HBP v1 2009-14.

2. I / We undertake to abide by provisions of FT (D&R) Act, 1992, as amended in 2010, the Rules and Orders framed thereunder, FTP and HBPv1 2009-14.

3. I/We hereby certify that I am / we are authorized to verify and sign this declaration as per Paragraph 9.9 of FTP.

Signature of the Applicant
Name
Designation
Official Address	Flat/Plot/Block No
	Street/Area/Locality
	City
	State
	PIN Code
Telephone No.	Country Code ----- Area Code ------ Phone number
		--	--
Fax No.		--	--
Email
Place:
Date:
Documents to be submitted:	i. One Copy of ANF 3B duly filled up and signed
	ii. CA / ICWA / CS certificate in format given in annexure to ANF 3B
	iii. Documentary evidence of earnings in Indian Rupees which are otherwise considered as having being paid for in free foreign exchange by RBI.
Note: Each page of application has to be signed

Annexure to ANF 3B

CERTIFICATE OF CHARTERED ACCOUNTANT (CA) / COST AND WORKS ACCOUNTANT (ICWA)/ COMPANY SECRETARY (CS)

I have examined prescribed registers and also relevant records of M/s..........................…… ……………………………having IEC number……………………... for period ………………… of the current financial year ……….. and certify that:

1.	Bills, Invoices, Forward Inward Remittance Certificates (FIRCs), Bank Realization Certificates, Certificate from international credit card companies, and evidences of foreign exchange earnings have been examined and verified by me.
2.	Services for which benefits is claimed does not include ineligible services and remittances as listed under Para 3.6.1 of HBP v1 2009-14.
3.	Neither I, nor any of my / our partners is a partner, director, or an employee of above-named entity, its Group companies or its associated concerns.
4.	Details of Foreign Exchange Earned for Supply of Service From India to outside India or in India, for the period …………………….. (as per frequency of application as at Sr.No.4 of ANF 3B) , is as under:
Category of Service Provider		Sl. No. of Appendix 10 / 41 of HBPv1	Free Foreign Exchange	Equivalent Indian Rupees
a.	Para 9.53 (i) of FTP
b.	Para 9.53 (ii) of FTP
c.	Para 9.53 (iii) of FTP
d.	Para 9.53 (iv) of FTP
Total (Rs)
I fully understand that any statement made in this certificate, if proved incorrect or false, will render me liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.
Signature of CA/ICWA/CS
Name of the Signatory
Designation
Membership No.