8. If application is for refund on TED
 

(Provision to be made to add multiple invoices)

9. Deleted
 

21. DBK-I Statement
 

22. Statement of inputs/components used, either imported or imported materials procured locally **
 

** Only inputs which were imported/ procured and consumed during the period commencing 90 days prior to the date of supply(s) shall only be taken into account for such claim.

A separate work sheet as per DBK form II, II(A), and certificates attached thereto duly certified by Chief Executive/production in-charge shall be submitted, as given in the APPENDIX-7E

23. Check List of documents to be attached duly scanned or submitted in the physical form at counter:

(1)

(a)Copy of Invoices or a statement of invoices duly signed by the units receiving the excisable goods and attested by Central Excise Authorities, as per the procedure prescribed by CBEC in their circular 15/2008-Cus. dated 26.9.2008. To facilitate attestation by Central Excise Authorities, intimation regarding receipt of goods should be given to the said authorities within 48 hours of receipt of goods. Corresponding ER-1/ER-3 or a monthly statement confirming duty payment attested by excise Authorities or Invoices/statement of Invoices certified by Jurisdictional Central Excise Authority of recipient.

(b) In case of supply of non-excisable goods, copy of Tax invoices as prescribed under GST Rules or a statement of invoices duly signed by the units receiving the goods and attested by Jurisdictional Customs Authorities, as per the procedure prescribed by CBEC in their circular 15/2008-Cus. dated 26.9.2008. To facilitate attestation by Jurisdictional Customs Authorities, intimation regarding receipt of goods should be given to the said authorities within 48 hours of receipt of goods.

(2) In case supply of goods to EOU/EHTPI STPI BTP, procedure prescribed in Circular No-14/14/2017-GST dated 6th November, 2017 issued by GST Policy Wing, Central Board of Excise and Customs, Department of Revenue shall be followed, Accordingly, copy of Form A along with copy of Tax Invoice duly endorsed by recipient shall be considered as proof of deemed export supplies,

(3) Self certified copy of B/Es

(4) Proof of payment through e-BRC/Bank Certificate of Exports and Realisation as per APPENDIX-2U or Payment Certificate issued by Project Authority in APPENDIX-7D in original, as the case may be.

(5) PAC issued by the Project Authority in original as per APPENDIX-7C or File No. where the original has been submitted.

(6) Copy of contract if supplies were to Project Authority or supplier’s copy of original ARO or recipient’s copy of original Invalidation Letter (if supply against ARO/Invalidation Letter issued against AA /DFIA/EPCG, as the case may be).

(7) Non-availment of CENVAT credit certificate as per ANNEXURE-I, by the recipient of finished goods (in case claim for TED).

(8) Deleted

(9) Declaration/disclaimer certificate from supplier, in case claim is filed by recipient of goods and from recipient of goods, if claim is filed by supplier of goods, as per ANNEXURE-II.

(10) Statement of supplies for Fixation of Drawback Rate as per APPENDIX-7E.
 

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 F.T. (D&R) Act, the Rules and Orders framed there under, the FTP, HBP, SION and the ITC(HS) Classification of Export & Import Items.

3. I/we further declare that the claim made by me/us is not a matter of right and I/we shall immediately refund the amount of TED/drawback obtained by us in excess of any amount/rate which may be re-determined by concerned RA / DGFT/Government as a result of post verification/Audit objection or otherwise.

4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI.

5. None of the Proprietor/Partners(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 under the adverse notice of DGFT or is in the caution list of RBI, to the bestof my knowledge.

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 AD/RBI permission has been obtained.

7. I/we further declare that the goods supplied are excisable goods but no CENVAT credit is availed/ available to the recipient of goods. (In case of items covered under schedule 4 of the central excise Act 1944).

8. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.06 of the FTP.
 

Signature of the Applicant
Name
Designation
Official Address
Telephone/Mobile No
Residential Address
Email Address
Place
Date



ANNEXURE-I

It is certified that no CENVAT credit under the Central Excise Rules has been availed by us, nor will be availed in future, on supply of these items as per the application.
 

Signature (Authorized Signatory):
Full Name:
Designation:
Name of the company:
Telephone Number:
E-mail Address:
Fax No:

Note: To be given on the letter head of the recipient of goods.
 

ANNEXURE-II

ANNEXURE-III

We hereby declare that we have neither drawn nor will draw any benefit of deemed export on supply of goods as declared/to be declared in the application for claim of deemed export benefits and we have no objection if M/s…… (Name and address of the recipient/supplier, as the case may be) draws the deemed export benefits on such supply of goods as mentioned in the application.

(Either party will have to give disclaimer in favour of other for not claiming benefits of deemed export against supply of goods as declared in the Application for claim. The disclaimer is to be submitted on the letter head of the firm/company)
 

Yours faithfully,
Signature (Authorized Signatory)
Full Name
Designation
Name of the company
Telephone Number
E-mail
Address Fax No

ANNEXURE-IV

FORMAT OF CERTIFICATE TO BE ISSUED BY PUBLIC SECTOR OIL COMPANIES CERTIFYING AMOUNT OF TED PAID BY EOU / PROJECT ON PURCHASE OF HSD FROM THEIR DEPOTS:

I _________ (name of authorized signatory of PSU Oil Company) hereby declare that we (name of the Company) have supplies HSD to M/s. __________(Name of EOU/Project) from our depot at-------- __________as per details given below.
 

Disclaimer Certificate:

We hereby certify that we are not claiming any deemed export benefits on the above supplies and we do not have any objection if _______ (Name of EOU/Project) claims deemed export benefits.
 

Authorized Signatory

(With full name and Designation)
 

8. If application is for refund on TED
 

(Provision to be made to add multiple invoices)

9. If the application is for drawback as per Col. “A” of AIR under drawback schedule:
 

(Provision to add multiple supply Invoices)
 

21. DBK-I Statement
 

22. Statement of inputs/components used, either imported or procured locally **
 

** Only inputs which were imported/ procured and consumed during the period commencing 90 days prior to the date of supply(s) shall only be taken into account for such claim.

A separate work sheet as per DBK form II, II(A), III and III(A) and certificates attached thereto duly certified by Chief Executive/production in-charge shall be submitted, as given in the APPENDIX-7E

23. Check List of documents to be attached duly scanned or submitted in the physical form at counter:

(1) Invoices or a statement of invoices attested by Central Excise Authorities, as per the procedure prescribed by CBEC in their circular 15/2008-Cus. dated 26.9.2008. To facilitate attestation by Central Excise Authorites, intimation regarding receipt of goods should be given to the said authorities within 48 hours of receipt of goods. Corresponding ER-1/ER-3 or a monthly statement confirming duty payment attested by excise Authorities or Invoices/statement of Invoices certified by Jurisdictional Central Excise Authority of recipient.

(2) In case supply of goods to EOU, ARE-3 duly certified by the recipient and their jurisdictional Central Excise Authority.

(3) Self certified copy of B/Es

(4) Proof of payment through e-BRC as per APPENDIX-2U or Payment Certificate issued by Project Authority in APPENDIX-7D in original, as the case may be.

(5) PAC issued by the Project Authority in original as per APPENDIX-7C or File No. where the original has been submitted.

(6) Copy of contract if supplies were made to Project Authority or supplier's copy of original ARO or recipient's copy of original Invalidation Letter, (If supply against ARO/Invalidation Letter issued against AA/DFIA/EPCH, as the case may be).

(Above entry at (6) has been revised vide PUBLIC NOTICE NO.14/2016, DT. 30/05/2016  effective from the 1st of April, 2015)

[OLD- (6) Copy of contract if supplies were to Project Authority or supplier’s copy of original ARO/Invalidation Letter (if supply against ARO/Invalidation Letter issued against AA /DFIA/EPCG). ]

(7) Non-availment of CENVAT credit certificate as per ANNEXURE-I, by the recipient of finished goods (in case claim for TED).

(8) A certificate regarding non-availment of CENVAT credit on inputs used in the resultant product by the supplier of goods as per ANNEXURE-II (in case claim for drawback).

(9) Declaration/disclaimer certificate from supplier, in case claim is filed by recipient of goods and from recipient of goods, if claim is filed by supplier of goods, as per ANNEXURE-III.

(10) Statement of supplies for Fixation of Drawback Rate as per APPENDIX-7E.
 

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 F.T.(D&R) Act, the Rules and Orders framed there under, the FTP, HBP, SION and the ITC(HS) Classification of Export & Import Items.

3. I/we further declare that the claim made by me/us is not a matter of right and I/we shall immediately refund the amount of TED/drawback obtained by us in excess of any amount/rate which may be re-determined by concerned RA / DGFT/Government as a result of post verification/Audit objection or otherwise.

4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI.

5. None of the Proprietor/Partners(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 under the adverse notice of DGFT or is in the caution list of RBI, to the best of my knowledge.

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 AD/RBI permission has been obtained.

7. I/we further declare that the goods supplied are excisable goods but no CENVAT credit is availed/ available to the recipient of goods.

8. I/we further declared that no CENVAT credit facility has been availed on inputs for which drawback claim is made.

9. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.06 of the FTP.
 

Signature of the Applicant
Name
Designation
Official Address
Telephone/Mobile No
Residential Address
Email Address
Place
Date

ANNEXURE-I

It is certified that no CENVAT credit under the Central Excise Rules has been availed by us, nor will be availed in future, on supply of these items as per the application.
 

Signature (Authorized Signatory):
Full Name:
Designation:
Name of the company:
Telephone Number:
E-mail Address:
Fax No:

Note: To be given on the letter head of the recipient of goods.
 

ANNEXURE-II

1. I, (Name & Designation) …..on behalf of M/s. ….. (Name and address of the supplier) hereby certify that we have supplied the following goods to M/s….. (Name and address of the recipient):
 

2. We are the manufacturer exporters/suppliers and are registered/not registered with Central Excise Authority and have not availed and will not avail CENVAT credit facility in respect of duty paid on inputs/components and/or tax paid on input services, in aforesaid supplies. We have also not availed and will not avail rebate on the duty paid on inputs/components used in aforesaid supplies and/or tax paid on input services.

3. We also certify that we have not been issued any Advance Authorization/Duty Free Import Authorization in respect of the aforesaid supply of goods and have not availed any benefit thereon.

4. The complete address of the Jurisdictional Assistant/Deputy Commissioner of the Central Excise Division is given as follows:
 

Yours faithfully,

Signature (Authorized Signatory)
Full Name
Designation
Name of the company
Telephone Number
E-mail
Address
Fax No.

Note: Declaration is to be given on letter head of the supplier. The Declaration furnished by the supplier to Office of the Development Commissioner or RA of DGFT should be in duplicate with complete address of the Jurisdictional Assistant/Deputy Commissioner of the Central Excise Division. The Development Commissioner/RA of DGFT would forward the second copy of this Declaration, duly stamped, to the addressed Assistant /Deputy Commissioner of the Central Excise Division for cross verification.
 

ANNEXURE-III

We hereby declare that we have neither drawn nor will draw any benefit of deemed export on supply of goods as declared/to be declared in the application for claim of deemed export benefits and we have no objection if M/s…… (Name and address of the recipient/supplier, as the case may be) draws the deemed export benefits on such supply of goods as mentioned in the application.

(Either party will have to give disclaimer in favour of other for not claiming benefits of deemed export against supply of goods as declared in the Application for claim. The disclaimer is to be submitted on the letter head of the firm/company)
 

Yours faithfully,

Signature (Authorized Signatory)
Full Name
Designation
Name of the company
Telephone Number
E-mail
Address
Fax No


ANNEXURE-IV

FORMAT OF CERTIFICATE TO BE ISSUED BY PUBLIC SECTOR OIL COMPANIES CERTIFYING AMOUNT OF TED PAID BY EOU / PROJECT ON PURCHASE OF HSD / FO FROM THEIR DEPOTS:

I _________(name of authorized signatory of PSU Oil Company) hereby declare that we (name of the Company) have supplies HSD/FO to M/s. __________(Name of EOU/Project) from our depot at-------- __________as per details given below.
 

Disclaimer Certificate:

We hereby certify that we are not claiming any deemed export benefits on the above supplies and we do not have any objection if _______(Name of EOU/Project) claims deemed export benefits.
 

Authorized Signatory
(With full name and Designation)]