1. IEC Number:

2. Applicant Details :

i. Name

ii. Address

3. Application Fee Details:

Amount (Rs)

Demand Draft/Bank Receipt/Electronic Fund Transfer No

Date of Issue

Name of the Bank and Branch on which DD drawn, if any

4 US Exporter Details:

i. Name

ii. Address

5. Name of the Sponsoring Directorate in ICIA:

6. Items of Import for which Import Certificate is required
 

* Export Control Classification Number of the item under US Department of Commerce Regulations (ECCN)

7. Purpose of Import:

a. If required for Manufacture please furnish:

i. IL/SIA/DGTD/SSI registration number

ii. End Product as given in registration certificate

iii. Actual items of manufacture

b. If required for Research & Development, please furnish:

i. Registration details with Department of Science & technology

ii. Validity of Registration

iii. Specific project for which items required

c. If required for Other Actual Users (Non Industrial), please furnish:

i. Registration Certificate details

ii. Permission details of local/municipal body

8. i. Whether the items of import are under Restricted List of ITC (HS)                     Yes/No

ii. File number of application submitted to Regional authority for Import License:

9. Reference Number, of the Controlled commodity / munitions list of US Export Administration Regulations, :

OR

Reference Number of the Crime Control (CC) Items as listed in Appendix 2P(iia) and Regional Security (RS) items as listed in Appendix 2P(iib)

10. Address of the factory / premises where the items to be imported are proposed to be used
 

1. I/We hereby certify that:
 

B. none of the Directors / Partners / Proprietor / Karta / Trustees of the company /firm /HUF/Trust, (as the case may be), is/are a Director(s) / Partner(s) / Proprietor / Karta / Trustee in any other Company/ firm / entity which is on the Denied Entity List (DEL) of DGFT;

C. neither the Registered Office of the company / Head Office of the firm / nor any of its Branch Office(s)/ Unit(s)/ Division(s) has been declared a defaulter and has otherwise been made ineligible for undertaking import / export under any of the provisions of the Policy;

D. we have not obtained nor applied for issuance of an Importer Exporter Code Number in the name of our Registered / Head Office to any other Licensing Authority

2. I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, as amended from time to time, the Rules and Orders framed there under, the Foreign Trade Policy, the Handbook of Procedures and the ITC (HS) Classification of Export & Import Items.

3. I/We fully understand that if any information furnished in the application is 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.

4. 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 withheld there from.

5. I _________________ (Name of the Organization), a Government entity/Government controlled entity/ private sector entity (Delete whichever is not applicable) hereby undertake

(i) To import the item into India and not to redirect it or any part of it, to another destination before its arrival in India;

(ii) To provide, if asked, verification that possession of item was taken;

(iii) Not to export the item without any written approval of Certificate Issuing Authority;

(iv) Not to transfer within India the item(s) specified in this certificate without the written approval of the Certificate Issuing Authority;

(v) To obtain permission in writing from the Certificate Issuing Authority prior to any change in end-user which shall be preceded by the new end-user notifying the Certificate Issuing Authority that he/she agrees to the conditions contained in this document;

(vi) The items being imported will/will not be integrated into Indian end-products to be exported.

6. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.06 of the Foreign Trade Policy.
 

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) a). ANF 1 has to be filed in by all applicants. In case of applications submitted electronically, hard copy of ANF1 is not required. However, in case where applications are submitted otherwise, hard copy of ANF1 has to be submitted.

b). Only relevant portions of Application need to be filled in.

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

a) Bank Receipt (in duplicate)/Demand Draft/EFT details evidencing payment of application fee in terms of Appendix 2K.

b) Self certified copy of letter from US supplier in support of request for Import Certificate

5) Items listed at both Appendix 2P (iia) and Appendix 2P(iib) will be allowed by DGFT for import from USA provided the importer submits the following documents in Appendix 2P(i)

I. documentary proof of Bill of Lading indicating Port of USA,

II. legal undertaking that goods shall not be exported/ alienated; and

III. Import is with Actual User condition.