ANF 4D
For clubbing of Advance
Authorisations
[ Please see guidelines (given at the end) before filling
the application ]
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2. Applicant Details
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i. Name
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ii. Address
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3. Details of Authorisations
to be clubbed
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S No
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Authorisation No
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Authorisation date
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Customs Notification no
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Export product
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Port of Registration
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1
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2
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3
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4
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5
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6
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CIF value permitted
(in Rs)
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CIF value used
(in
FFE)
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EO imposed (FFE)
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Exports made
(FFE)
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Expiry date of initial EO period
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Expiry date of extended EO period
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7
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8
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9
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10
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11
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12
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4. Details of physical exports / deemed exports made against each individual Advance
Authorisation
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S
No
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Products Exported/ Supplied
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Shipping Bill/ Invoice/ AR 3 Details
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Quantity Exported / Supplied
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FOB Value
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No
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Date
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Direct exports
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Third Party exports
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Deemed Exports
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Total
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In case of physical exports (as per S/B)
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In case of deemed exports (as per invoices)
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Actually realized (as per BRC)
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5. Details of imports allowed and made against each individual Authorisation
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S No
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Item of Import
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Qty allowed in the Authorisation
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CIF Value allowed in the Authorisation
( in FFE)
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Bill of Entry Details
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Quantity
imported
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CIF Value
used
(in FFE)
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No
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Date
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6. Consolidated Details of physical exports / deemed exports made against all Authorisations
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S No
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Products Exported / Supplied
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Shipping Bill/ Invoice / AR 3 Details
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Quantity Exported / Supplied
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FOB Value
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No
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Date
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Direct exports
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Third Party exports
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Deemed Exports
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Total
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In case of physical exports (as per S/B)
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In case of deemed exports (as per invoices)
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Actually realized (as per BRC)
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7. Consolidated Details of imports allowed and made against all Authorisations
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S No
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Item of Import
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Qty allowed in the Authorisation
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CIF Value allowed in the Authorisation
( in FFE)
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Bill of Entry Details
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Quantity
imported
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CIF Value
(in FFE)
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No
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Date
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8. Details of excess imports made
proportionate to the export obligation fulfilled
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S No
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Item of Import
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Bill of Entry Details
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Quantity
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Duty Details
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No
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Date
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Customs Duty
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Interest
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Total
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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. 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 FT(D&R) Act, the Rules and Orders
framed there under, the FTP, HBP v1, HBP v2 and the ITC(HS) Classification of Export
& Import Items.
3.
I / We hereby certify that none of the Proprietor/ Partner(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 to the
adverse notice of DGFT.
4.
I/We hereby certify that the Proprietor / Partner(s) / Director(s) / Karta /Trustee,
as the case may be, of the firm/company is/are not associated as Proprietor/Partner(s)/Director(s)/Karta/Trustee
in any other firm/company which is in the caution list of RBI.
5.
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, 2004-09 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 HBP v1, irrespective of the scheme under which the item is exported
/ proposed to be exported (the underlined portion will be deleted in case an application
for export license for SCOMET item is being filed).
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
RBI permission has been obtained.
7.
I hereby certify that I am authorised to verify and sign this declaration as per
Paragraph 9.9 of the FTP.
Signature of the
Applicant Place
Name
Date
Designation
Official Address
Telephone
Residential Address
Email Address