ANF 4 I
GEM
REP Application
[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. RCMC Details
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i. RCMC Number
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ii. Date of Issue
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iii. Issuing Authority
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iv. valid upto
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Products for which registered
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4. Type of Exporter (please tick)
( √ )
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i. Merchant Exporter
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ii. Manufacturer Exporter
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iii. Service Provider
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iv. Others (please specify)
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v. Merchant cum Manufacturer
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5. Industrial Registration Details
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i. SSI
/ IEM / LOI or IL
Registration Number
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ii. Date of Issue
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iii. Issuing Authority
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iv. Products for which registered
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6. Excise Details (For those registered with Central Excise Authority)
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i. Excise Registration Number
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ii. Issuing Authority
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7. Application Fee Details
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Amount (Rs)
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Demand Draft / Bank Receipt
/ Electronic Fund Transfer No
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Date of Issue
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Name of the Bank on which drawn
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Bank Branch on which drawn
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8. Export Proceeds Realisation Month:
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9. FOB Value of Exports
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i. In free foreign exchange
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ii. In Rupees
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10. Value of Authorisation
Claimed
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i. In free foreign exchange
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ii. In Rupees
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11. Details of exports made
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Name of the Bank
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Shipping Bill/ Postal Receipt
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FOB Value
( in FFE / Rs )
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FOB Value realised
( in FFE / Rs )
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REP Authorisation Claimed ( Rs )
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Country of Exports
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Number
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Date
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Note: In case application for REP Authorisation
is made under Para 4A.28 of this handbook, serial no 11 may be left blank
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
GUIDELINES FOR APPLICANTS
[ Please see paragraph 4 A.1
and 4A.28
of HBP v1 ]
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.
RCMC details need not be given if the same has already given at the time obtaining
IEC.
4.
Application must be accompanied by documents as per details given below:
a.
Bank Receipt (in duplicate)/Demand
Draft evidencing payment of application fee in terms of Appendix 21B.
b.
Bank certificate of export
and realisation in the format given in Appendix 22A evidencing realisation of exports
proceeds/sales proceeds.
c.
Export Promotion (EP) copy
of Shipping Bill(s) in Original. (Photocopy of the EP copy of Shipping Bill duly
endorsed may be returned for utilization/re-import purposes when the exports are
made on consignment basis).
d.
Customs attested invoice.
e.
In case of application for Replenishment
Authorisation under paragraph 4A.28 of this Handbook, an applicant will
be required to submit documents as given at S.No.1 above and Statement of Exports
made during the preceding licensing year duly certified by Chartered Accountant
/ Cost & Works Accountant in the format given in Appendix 26.
Annexure to
ANF 4 I
CERTIFICATE OF CHARTERED
ACCOUNTANT COST AND WORKS ACCOUNTANT
I/We hereby confirm
that I/We have examined the prescribed registers and also the relevant records of
M/s..........................……………………………………………having IEC number……………………... and PAN
number…………………….for the licensing period(s) ………………………………and hereby certify that:
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(i)
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The following documents/
records have been furnished by the applicant firm/company and have been examined
and verified by me/us namely: -
a.
Statutory documentation
under the Customs Act 1962 and Excise Act 1848, Service Tax Act, Foreign Trade (Development
& Regulation) Act 1992;
b.
Export Order/Contract,
Shipping Bills, Bill of Lading (and/or Airways Bills/PP Receipts), Customs/Bank
attested Invoices, Bank Certificates of exports made in their own name, GR declaration
etc and connected books of accounts;
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(ii)
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The relevant accounting
and financial register(s) as prescribed under different Acts and Rules made there
under have been maintained and authenticated under my/our seal and signature.
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(iii)
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The information given
by the applicant firm/company in the ‘Aayaat Niryaat Form’ including details on
a.
imports/exports made,
b.
foreign exchange earnings/
realization (both from direct and indirect sources)
is in agreement with
the Foreign Trade Policy 2004-09 and the rules and procedures made there under,
the relevant register and records and the books of accounts maintained by M/s...........…………………...
and their subsidiaries and is also true and correct.
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(iv)
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It has been ensured
that the information furnished is true and correct in all respects; no part of it
is false or misleading and no relevant information has been concealed or withheld;
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(v)
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Neither I, nor any of
my/our partners is a partner, director, or an employee of the above-named entity,
its Group companies or its associated concerns;
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(vi)
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I/We further certify that M/s..................……………………….
has realised 95% or more of the export proceeds in respect of exports made by him
in the preceding three licensing years [excluding the export made during last 360
days (for status holders) and six months for others, from the date of filing of
application]
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(vii)
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I/We fully understand
that any statement made in this certificate, if proved incorrect or false, will
render me/us liable to face any penal action or other consequences as may be prescribed
in law or otherwise warranted.
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S.No
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Shipping Bills Nos
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Date of Let Export
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Description of product
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FOB value (in rupees)
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(Signature
and Stamp/ Seal of the Signatory)
(Chartered Accountant/ Cost & Works Accountant)
Name of the Signatory:
Place:
Address:
Date:
Membership No:
If any of the documents
of
record
mentioned in serial number (i)
have
not
been maintained/ furnished,
examined or verified, they may please be specified below:-
1.
2.
Note:
Each page of this annexure
is to be signed by the Chartered Accountant / Cost &
Works
Accountant with his registration number