ANF 5B
Statement of Export for Redemption of EPCG/ Annual EPCG Authorization
Part A
|
1. Applicant Details |
|
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 |
|
|
Products 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 |
|
6. Industrial Registration Details |
|
i. SSI / IEM / LOI or IL Registration Number |
|
|
ii. Date of Issue |
|
|
iii. Issuing Authority |
|
|
iv. Products for which registered |
|
|
7. Excise Details (For those registered with Central Excise Authority) |
|
i. Excise Registration Number |
|
|
ii. Issuing Authority |
|
|
8. Status House Details: |
|
i. EH / SEH / TH / STH / PTH |
|
|
ii. Certificate Number |
|
|
iii. Date of Issue |
|
|
iv. Issuing Authority |
|
|
v. Valid Upto |
|
Part B
|
9. EPCG Authorisation Number & date |
Actual duty saved amount |
|
10. Export obligation period (EOP) |
|
i. Original date |
|
|
ii. Extended EOP date |
|
|
iii. Actual EO Completion date: |
|
10A. Details of completion of imports and Bill of Entry/Entries.
|
Sl.No. |
BE No. |
DT of BE |
DUTY PAID (in Rs.) |
DUTY SAVED (in Rs.) |
|
1 |
|
|
|
|
|
2 |
|
|
|
|
(Above Sl. No. 10A has been added vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012)
|
11. Date of Installation of capital goods
[OLD- 11. Installation certificate No. & Date ]
|
|
|
|
|
(Above Sl. No. 11 has been substituted vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012) |
|
12. Export Product Details: |
|
i. Same / similar product name & ITC(HS) code. |
|
|
ii. Alternate Product name & ITC(HS) code. |
|
|
13. Export Obligation (EO) imposed |
EO as per actual duty saved amount/ Average EO |
|
In Indian Rs. |
In US$ |
In Indian Rs. |
In US$ |
+ In case of alternate product export of average EO of alternate product should be given.
14.Details of physical exports/deemed exports made/services rendered for maintaining specific EO of Authorization for which this redemption is sought
|
|
S No |
Products Exported/ Supplied/Services rendered ITC(HS) Code. |
Shipping Bill/ Voucher/Invoice/ CT 3 / ARE 3/ Lorry Receipt/ Railway Receipt Details + |
FOB / FOR value(in FFE) ++ |
|
|
Same Product/Services ------------------ Alternative Product / Services |
No |
Date |
Direct exports |
Third Party exports |
Deemed Exports |
By Group Company |
Other R&D Services / Royalty |
Total |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
+ not to be filled in by hotel industry
++ Only Exports/ Supplies made/ capable of being made/ services rendered out of capital goods imported under the Authorisation for discharge of export obligation imposed on the Authorisation and export proceeds realized to be included.
15. We further declare that we have made exports as under for maintenance of Average export obligation (other than that mentioned in 7 above) Exports.
(As per suggestion
|
FINANCIAL YEAR |
TOTAL VALUE OF EXPORTS (OTHER THAN EXPORTS UNDER SPECIFIC EO) INR |
DETAILS OF SHIPPING BILLS FOR FULFILLMENT OF AVERAGE EXPORT OBLIGATION. |
|
|
|
|
1. The exports indicated at Sl. No.15 do not include exports covered under Sr. No.14 above.
2. The exports indicated at Sl. No.15 do not include exports rendered for maintaining specific EO of other EPCG authorizations.
(Above NOTEs at Sl. No. 15 has been substituted vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012)
[OLD- This column does not include exports covered under Sr. No.7 above.
2. this column does not include exports rendered for maintaining specific EO of other EPCG authorizations. ]
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 and 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.
2. 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, 2009-14 and 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 Handbook of Procedures (Vol.1), irrespective of the scheme under which the item is exported / proposed to be exported [Deleted - (the underlined portion will be deleted in case an application for export license for SCOMET item is being filed). ]
(The phrase "(the underlined portion will be deleted in case an application for export license for SCOMET item is being filed)" has been deleted vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012)
3. I/We hereby declare that exports counted towards Specific Export Obligation against this licence have not been claimed /counted for fulfillment of annual average export performance / specific export obligation against other EPCG Authorization.
4. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.9 of the Policy.
Place
Date |
Signature of the Applicant
Name
Designation
Official Address
Residential Address
Email:
Telephone No.(O): |
5. It is certified that all physical exports made as shown in item Nos. 7 & 8 above are in freely convertible currency and payment of the same has been realized*.
Signature with Seal of the Chartered Accountant
6. It is certified that (a)F.I.R.C. have been checked by me and (b) payment received is for export of Services allowed for E.O. fulfilment in the EPCG Authorization.
(Above Sl. No. 6. has been added vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012)
* Deleted.
Note: Realization of export proceeds shall not be insisted, if the Reserve Bank of India (RBI) writes off the requirement of realization of export proceeds on merits and the exporter also produces a certificate from the Foreign Mission of India about the fact of non recovery of export proceeds from the buyer. However this would not include self write off cases.
I/We hereby declare that Freight, Insurance and Commission values as mentioned in the application are based on actual transaction values.
For the purpose of calculating entitlement, commission amount has been excluded.
(Above 2 declarations/undertaking has been added vide PN NO. 21/2012, DT. 09/10/2012)
GUIDELINES FOR APPLICANTS
1. Appendix 26A duly signed by Chartered Accountant must be submitted.
2. Each individual page of the application has to be singed by the applicant.
3. Application must be accompanied by documents as per above details except those which have been submitted alongwith ANF 5A.
[OLD- 3. Application must be accompanied by documents as per above details. ]
4. Original EPCG authorization(s) must be submitted.
(Above Sl. No. 3. - substituted and Sl. NO. 4 added vide PUBLIC NOTICE NO. 32/2012, DT. 27/11/2012)
Presented by eximkey.com