APPENDIX - 10D
- Document type
- Procedure
- Dated
APPLICATION FORM FOR GRANT OF DUTY FREE REPLENISHMENT CERTIFICATE
APPLICATION FORM FOR GRANT OF DUTY FREE REPLENISHMENT CERTIFICATE
1. Please see paragraph 4.2 of the Policy and Paragraph 4.33 to 4.36 of this Handbook.
2. Please read the general instructions given at Appendix-1 before filling this application.
3. Please submit 2 copies of this application.
File Number:---------------------------------------------------- Date:--------------------------------------
| 1. | Name and address of the applicant | : ....................................... |
| 2. | I.E. Code No.: | : ....................................... |
| 3. | Export Product Group: | : ....................................... |
| 4. | S.No(s) of Standard Input-Output Norms or wastage norms as per 4.56 of Handbook for exports of gold/ silver/ platinum jewellery and articles thereof: | : ....................................... |
| 5. | Total FOB/ FOR value realised (including commission) | Rs.............. In currency ........... in US$ ............... |
| 6. | Total CIF value of imports: | Rs. ............ in currency ........... in US $ ................... |
| 7. | Value addition: |
| 8. | Application fee | a) Bank Receipt/ Demand Draft No. and date | : ..................................... ....................................... |
| b) Rupees: | : ..................................... ....................................... | ||
| c)Issued by : | : ..................................... ....................................... |
| 9. Port of registration. | : ....................................... |
| 10. Details of the product exported/ deemed supplies made (Resultant Products). | |
| S.No. | Resultant product | Total quantity | Unit of measurement | FOB/ FOR value | |||||
| Description of export/ supplied product | S.No. of SION | ITC(HS) Code | Name | Code | In rupees | In freely convertible currency (FCC) ( if applicable) | |||
11. Details of Items sought to be imported Duty free as replenishment.
| S.No | Import item | Technical Characteristics (for sensitive items as per paragraph 4.31) | Total quantity | Unit of measurement (U/M) | ||
| Description | ITC(HS) Code | Name | Code | |||
12. Details of other materials used in resultant product and imported/ procured from sources other than the licence.
| S.No | Resultant product(s)(description of export product) | Total quantity | Imported item | Indigenously procured item | ||||
| Description | Quantity and U/M | CIF value | Description | Quantity and U/M | Value | |||
2. I/We fully understand that any information furnished in the application if proved incorrect or false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.
3. I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, the Rules and Orders framed thereunder, the Export and Import Policy and the Handbook of Procedures.
4. I/We further declare that no export proceeds are outstanding beyond the prescribed period as laid down by the RBI, or such extended period for which RBI permission has been obtained.
5. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the Policy.
Place :
Date :
Signature of the Applicant: ........................
Name: ........................
Designation: ........................
Official Address: ........................
........................
Tele No: ........................
E-Mail Address ........................
1. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-29.
1. Proof of Exports/ Supplies:
2. A) For physical exports an EP copy of the Shipping Bill or Bill of Export (only in case of exports through through notified land Customs under paragraph 4.19).
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B) In case of deemed exports a copy of the invoice duly signed by the unit receiving the material and their jurisdictional excise authorities certifying the item of supply, its quantity, value and date of such supply. However in case of supply of items which are non excisable or supply of excisable items to a unit producing non excisable product(s), a project authority certificate (PAC) certifying quantity, value and date of supply would be acceptable in lieu of excise certification. Notwithstanding the above, in respect of supplies to EOU/SEZ, a copy of ARE-3 duly signed by the jurisdictional excise authorities certifying the item of supply, its quantity, value and date of such supply shall be furnished.
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a) For Physical Exports: Bank Certificate of Exports and Realisation as given in Appendix 22 or Foreign Inward Remittance Certificate (FIRC) in the case of direct negotiation of documents or Appendix22B in the case of offsetting of export proceeds with the approval of RBI. In case of FIRC, a declaration from the exporter that the remittance is in respect of Shipping Bill(s) No ____________ dated _________ shall also be furnished.
b) For Deemed Supplies: Payment certificate from the project authority as per Appendix-12A or a payment certificate or bank certificate of payment for domestic supplies as per appendix-22A whichever is applicable.