ANNEXURE-50

Application for suppliementary claim for drawback under Rule 15 of Customs and Central Excise Duties Drawback Rules, 1995
(Where the drawback received falls short of the rate finally fixed by the government, application for supplimentary claim of drawback should be made in the following form)

To,

The [Assistant Commisioner of Customs]-in-Charge
Drawback Department

We hareby make a supplimentary claim for drawback of Customs/Central Excise which has been less paid to us as explained herein.

1. Exporter

(a) Name
(b) Address
(c) Telephone No.
(d) Name of Clearing Agent.

2. Goods exported

(a) Description
(b) Quantity

(i) Gross
(ii) Net

(c) Marks & No.
(d) Destination
(e) Shipping Bill No. & Date

3. Vessel

(a) Name
(b) Rotation No.

4. Drawback already paid

(a) Amount
(b) Custom House Reference No.
(c) Quantity /Value on which allowed
(d) Rate at which allowed

5. Drawback now claimed

(a) Amount
(b) Quantity/Value on which allowed
(c) Rate at which claimed

6. Reason for the supplementary claim.

7. No. of documents enclosed.*

DECLARATION
1. I/We hereby declare that the supplementary claim of drawback is based on the Customs and Central Excise Duties paid on the raw materials used in the manufacture of goods/exported the duties so paid have not been claimed as rebate under the Central Excise Rules, 1944.

2. I/We hereby declare that the declaratin made herein is true and correct.

Signatuer_______________
Designation_____________

* Please enclose copy of communication regarding rate of drawback determined under rule 6 or 7, any other document in support of supplementary claim, or other documents as may be prescribed by [Commissioner of Customs.].
Please also enclose calculation sheet.

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