APPENDIX - 9A
STATEMENT OF EXPORT/ REDEMPTION FORM UNDER EPCG SCHEME
NOTE: PLEASE SEE PARAGRAPH 5.4 AND 5.13 OF THIS HANDBOOK
| a) | Name & Address of the Licence holder | :
|
| b) | EPCG Licence No. & Date | :
|
| c) | CIF Value | (i) Issued :
(ii) Utilised :
|
| d) | Export Obligation w.r.t imports effected under the EPCG Licence.
| : |
i) Export obligation equal to
(a) five times of the CIF value of capital goods
or
(b) eight times the duty saved on import/ deemed import of the capital goods
or
(c) six times the duty saved on import/ deemed import of the capital goods in case of Technological Upgradation. ii) Average exports to be maintained
| :
:
:
: |
| e) | Product exported as per the conditions attached to the EPCG licence
| : |
| f) | Date of clearance of the first consignment of capital goods under the EPCG Licence from the customs authorities/Date of receipt of CG from indigenous source
| : |
| g) | Date of completion of export obligation
| : |
| h) | Details of Exports
| : |
i) Year/Block of year from the date of issue of licence:
| : |
ii) Proportion of total Export Obligation fulfilled:
| : |
iii) Details of physical/ deemed exports:
| |
| S.No. | Product Exported/ Supplied | Shipping Bill No.& Date/ Invoice No/ AR-3 No & date/Lorry/ Railway receipt number and date | FOB value of exports/ FOR value of supplies |
| | | | Exports/Supplies made/capable of being made out of imported capital goods to discharge E.O. imposed on the Licence and export proceeds realised |
| | | | Direct exports | Third Party exports | Deemed exports | Royalty payments in FCC | Forex for R&D services | Total |
| (1) | (2) | (3) | (4a) | (4b) | (4c) | (4d) | (4e) | (5) |
| | | | | | | | | |
iv) We further declare that we have made exports and supplies for maintenance of average (other than that mentioned in iii) above) as per the following details.
| Year | Shipping Bill No.& Date/ Invoice No/ AR-3 No & date/Lorry/ Railway receipt number and date | FOB value of exports/ FOR value of supplies | Average to be maintained as per para 5.4 of Policy |
| | | Direct exports | Third Party exports | Deemed exports | Royalty payments in FCC | Forex for R&D services | Total | |
| (1) | (2) | (3a) | (3b) | (3c) | (3d) | (3e) | (3a to 3e) | (4) |
| | | | | | | | | |
We hereby declare that the above particulars are correct
Signature with seal and
Designation of the exporter
It is certified that we have verified the books of accounts Books of the above exporter and the particulars given above in respect of export both physical and deemed, are correct.
1. It is also certified that all the shipping bills verified by me/us as mentioned in (h) iii) above contained in the EPCG Licence No. and date as given at Sl.No.b) above.
2. It is certified that we have certified the book of accounts of the above exporter and the particulars given above in respect of Third Party Exports are correct. It is also certified that all the shipping bills of the third party verified by me/us as mentioned in (h) iii) above contained the EPCG Licence No. & date and the EPCG licence holder as given at Sl.No.b) above.
3. It is certified that we have certified the book of accounts of the above exporter and the particulars given above in respect of Deemed Exports are correct. It is also certified that all the invoices and AR-3 form verified by me/us as mentioned in (h) iii) have been duly certified by the Excise authorities.
Signature with seal of the
Chartered Accountant/Cost
& Works Accountant
Membership No.
1. This is certified that all physical exports as shown in iii) & iv) above are in freely convertible currency and payment of the same has been realised.
2. Similarly payments for all the deemed exports as indicated in (h) iii) have been realised through the normal banking channels as per the following details.
| Invoice | Description of goods as given in the invoice | Details of payment/ advance payment received |
| No. | Date | FOR value | Cheque /DD No./ *Bank Ref. No. | Date | Amount |
| [1] | [2] | [3] | [4] | [5] | [6] | [7] |
| | | | | | | |
(* The Bank Reference Number would be applicable for documents routed through bank & payments released through banking channels.)
Signature with the seal of the Bank
Date:
Bank Code No.
- Note:
- 1. The consolidated statement may be submitted only at the time of seeking redemption of BG/LUT and the statement should be complete in all respects including the information in S.No.(3)column (4) above duly certified by Chartered Accountant as well as by the Bank.
Documents to be enclosed with the application form:
1) Copy of bill of entry/ licence showing the date of clearance of the first consignment.
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