ANF 3B
Application for Served from India Scheme (SFIS)
(for Foreign Exchange Earned during 2006-07)
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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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v. Products for which registered
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4. Category of Service Provider (please tick)
( √ )
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i. Individual Service Provider
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ii. Hotels & Restaurants
and other service Providers in Tourism Sector except Stand-alone restaurant.
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iii. Stand Alone Restaurant
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iv. All other Service Providers
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5. Foreign Exchange Earned for
rendering of Service from India to (outside India or In India)
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Sr. No.
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Supply of Service by Service
Provider
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Foreign Exchange Earned
(Rs)
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1
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Supply of a ‘service’ from India to any other country under
Para 9.53 (i) of FTP.
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2
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Supply of a ‘service’ from India to service consumer of any other country in India
under
Para 9.53 (ii) of FTP.
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3
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Supply of a ‘service’ from India through commercial or physical presence in territory
of any other country under Para 9.53 (iii) of FTP.
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4
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Supply of a ‘service’ in India relating to exports paid in free foreign exchange
or in Indian Rupees which are otherwise considered as having being paid for in free
foreign exchange by RBI under Para 9.53 (iv) of FTP by Hotels & Restaurants and other service Providers
in Tourism Sector except Stand-alone restaurant.
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5
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Supply of a ‘service’ in India relating to exports paid
in free foreign exchange or in Indian Rupees which are otherwise considered as having
being paid for in free foreign exchange by RBI under Para 9.53 (iv) of FTP by categories
4(i), 4(iii), and 4(iv) above.
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Total
(Rs)
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Entitlement of SFIS (Rs) = [(5%*Row
4) +10%* (Total – Row 4)]
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6. Port of Registration (for purpose of Imports):
7. Number of Split Certificates required (in multiples of Rs 5 lakhs each):
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8. Application Submission Details (in case of electronically submitted applications)
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9. Application Fee Details
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i. ECOM Reference
Number
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(i)
Amount (Rs):
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ii. Date of Submission on
Server
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(ii)
Demand Draft / Bank Receipt
/ Electronic Fund Transfer No
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iii. Submitted to which Regional
Authority
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(iii)
Date of Issue
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iv. File Number
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(iv)
Name of the Bank on which drawn
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v. Date of Issue
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(v)
Bank Branch on which drawn
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DECLARATION / UNDERTAKING
1.
I hereby declare that particulars and statements made in this application are true
and correct and nothing has been concealed or held therefrom. I fully understand
that any information furnished in application if found incorrect or false will render
my firm / company and me liable for any penal action or other consequences as may
be prescribed in law or otherwise warranted.
2.
I hereby certify that none of Proprietor/ Partner(s) / Director(s) / Karta / Trustee
of firm / company, as the case may be, is a Proprietor / Partner(s) / Director(s)
/ Karta / Trustee in any other firm / company which has come to adverse notice of
DGFT.
Consequentially, I further declare that under Foreign Trade (Development and Regulation)
Act (FT (D&R) Act) 1992, my firm / company have not been debarred in person
from undertaking any export import business or activity by way of suspension or
cancellation of IEC number. [If so debarred under FT (D&R) Act, details of said
order and period for which the same is operational may be provided].
3.
I hereby certify
that my firm / company has not defaulted from export obligation under any provisions
of FTP and has not been placed under the Denied Entity List (DEL). [If under DEL
List, kindly furnish details of order, current status etc.]
4.
I hereby declare
that details of exports of goods and services of my firm / company are true and
correct and in accordance with accounts maintained in my firm / company.
5.
I hereby certify
that foreign exchange earned on account of services rendered from India alone has
been taken into account for this application under SFIS and these do not fall under
any category or service which are not eligible as per Para 3.18.1 of HBP v1.
6.
I further declare
that other sources of foreign exchange earnings such as equity or debt participation,
donations, repayment of loans and any other inflow of foreign exchange unrelated
to service rendered has not been considered.
7.
I hereby declare that benefits is being claimed for only those earnings in Indian
Rupees which are otherwise considered as having been paid for in free foreign exchange
by RBI.
8.
I hereby undertake to submit
to Regional Authority (with a copy to jurisdictional Excise Authorities), a
statement
of imports made under SFIS within one month of completion of imports or expiry of
validity
of duty credit scrip, whichever is earlier.
9.
I hereby undertake
that imports to be made under this duty credit scrip shall be related to any service
sector business and I further undertake that such imported goods shall not be sold
/ transferred / disposed off in a manner in contravention to provisions of FTP.
I further undertake to abide by provisions of Para 9.53 of FTP relating to supply
of service from India.
10. I undertake
to abide by provisions of FT (D&R) Act, 1992, Rules and Orders framed there
under, and FTP.
11.
I hereby certify that I am authorized to verify and sign this declaration as per
Paragraph 9.9 of FTP
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Place: ____________
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Signature: ________________________________
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Date: _____________
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Name: ___________________________________
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Documents to
be submitted
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Designation: ______________________________
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1.
Documentary evidence for payment
of Application Fee
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Official Address: ___________________________
_________________________________________
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2.
CA / ICWA / CS certificate in format given in annexure to ANF 3B.
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Telephone: _______________________________
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Residential Address: ________________________
_________________________________________
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Note: Each page of application
has to be signed.
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Email Address: ____________________________
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Annexure
to ANF 3B
CERTIFICATE OF CHARTERED
ACCOUNTANT (CA)
COST AND WORKS ACCOUNTANT (ICWA)/ COMPANY SECRETARY (CS)
I hereby confirm that
I have examined prescribed registers and also relevant records of M/s..........................……
………… …………………having IEC number……………………... for licensing period (previous year) …………………
and hereby certify that:
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(i)
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Following documents
/ records have been furnished by applicant individual / firm / company and have
been examined and verified by me / us namely: -
Forward Inward Remittance
Certificates (FIRCs), Bank Realization Certificates, Certificate from international
credit card companies,
and evidences of foreign exchange earnings as well as the
connected books of accounts.
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(ii)
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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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Information given by
applicant in ANF 3B including details on Services rendered From India as per Appendix
10 of HBP v1 (with relevant sr. no. and description) is true and correct.
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(iv)
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Services for which benefits
is claimed does not include ineligible services and remittances as listed under
Para 3.18.1 of HBP v1.
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(v)
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It has been ensured
that 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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(vi)
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Neither I, nor any of
my / our partners is a partner, director, or an employee of above-named entity,
its Group companies or its associated concerns;
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Place: ______________
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Signature of CA/ ICWA / CS:_______________________
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Date: _______________
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Name of the Signatory: ______________________
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Address: _________________________________
_________________________________________
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Membership No: ___________________________
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Email Address: _________________________________
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Annexure
to ANF 3B (continued)
-2-
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(vii)
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Certificate of Foreign Exchange Earned by Supply of Service
from India to (outside India or In India) is as under:
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Certificate of Foreign Exchange Earned by Supply of Service from India to
(outside India or In India)
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Sr. No.
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Category of Service Provider
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Sr. No. of Appendix 10
(within each category)
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Foreign Exchange Earned
(Rs)
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1
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Para 9.53 (i)
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i)
…
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2
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Para 9.53 (ii)
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i)
ii)
iii)
…
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3
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Para 9.53 (iii)
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i)
ii)
…
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4
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Para 9.53 (iv)* for Category 4(ii) of Sr. No 5 of ANF 3B
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i)
ii)
iii)
….
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5
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Para 9.53 (iv)* for Category 4(i), 4(iii), 4(iv) of Sr.
No 5 of ANF 3B
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i)
ii)
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Total Foreign Exchange Earned by Supply of Service
from India to (outside India or In India)
(Rs)
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*Includes payments received in Indian Rupees that are otherwise
treated as deemed to be realized in free foreign exchange – See Para 9.53 (iv).
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(vii)
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I fully understand that
any statement made in this certificate, if proved incorrect or false, will render
me liable to face any penal action or other consequences as may be prescribed in
law or otherwise warranted.
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Place: ______________
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Signature of CA/ ICWA / CS:_______________________
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Date: _______________
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Name of the Signatory: ______________________
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Address: _________________________________
_________________________________________
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Membership No: ___________________________
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Email Address: _________________________________
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