(APPENDIX 17D - TPS for exports effected during 2005-06)

[OLD-
APPENDIX 17-D

Application Form for Target Plus Entitlement for Exports Effected During 2004-05

(Please see paragraph 3.7.1 to 3.7.8 of the Foreign Trade Policy and 3.2.5 of the Handbook (Vol. 1))

FOR OFFICIAL USE

File No._________________________________

Date:____________

1.	Name and Address	:
2.	I E Code Number	:
3.	Details of Status Certificate
	For the year 2004-‘05 a) Status b) Status Certificate Number c) Date of Issuance d) Valid from e) Valid up to	:1 / 2 / 3 / 4 / 5 Star Export House / EH / TH / STH / SSTH (tick the relevant Status) : : : :
4	RCMC No. and Date	:
	Issued by	:

5. Details of All Star Export Houses of the Group (see Note 1)

Sr.No.	Names of the GroupCompany	Status of the Company (1 / 2 / 3 / 4 / 5 Star Export House / EH / TH / STH / SSTH)	Eligible Export Turnover (Rupee in Crores)
			2003-04	2004-05
1
2
3
	Total Group Turnover of all the Star Export Houses

6. Calculation of Value of Export and Entitlement: (see Note 2 to 10)

Sr.No.	Categories	FOB Value of Exports in US$
		A	B
		2003-04	2004-05
Row 01	Annual Export Turnover
Row 02	Exports made in categories (a to g) mentioned at Sr. No. VI of the declaration appended hereto
Row 03	Eligible Exports = Row 1-Row 2
Row 04	Incremental Growth Percentage= 100*(Column B of Row 3-Column A of Row 3)/ Column A of Row 3 (in %)
Row 05	Target Plus Entitlement Rate to be applied (%) (Fill in 5 / 10 / 15 % as the case may be)
Row 06	Eligible Exports (in Rupees)
Row 07	FOB Value of Exports under Vishesh Krishi Upaj Yojana (in Rupees)
Row 08	Eligible Export for Duty Free Credit Entitlement (in Rupees) =(Row 6 - Row 7)
Row 09	Percentage of amount Realized as per Bank Realization Certificate out of Row 8 in the Year 2004-05 (in %)
Row 10	Value Cap on Target Plus Duty Free Credit Entitlement (in Rs) = Column A of Row 08 X Rate in Row 05
Row 11	Total Target Plus Duty Free Credit Entitlement Eligible for (in Rs) = Rate in Row 05 X [Column B of Row 8-Column A of Row 8] or Value Cap of Target Plus Duty Free Credit Entitlement in Row 10 above, whichever is lower
Row 12	Value for Target Plus Duty Free Credit Entitlement applied for (in Rs) = Rate in Row 05 X [Row 09 X Column B of Row 8-Column A of Row 8] or (Value Cap on Target Plus DFCE in Row 10 X Row 9) whichever is lower
Row 13	Balance Target Plus Duty Free Credit Entitlement due (in Rs) = Row 11 - Row 12
[Deleted- Row 14	Value wise details of Product Groups Sr. No. Product Groups FOB Value of Eligible Exports in Rs (2004-05) 1 Engineering   2 Chemicals   3 Plastics   4 Leather & Leather Products   5 Sports Goods   6 Fish & Fish Products   7 Food Products   8 Handicrafts   9 Electronics   10 Textiles   11 Miscellaneous   ]

7. Breakup for the Split–up Target Plus Entitlement, if any, requested for:

Sr.No.	Entitlement	Break-up of the Entitlement for split-up

8. Details of the Application Fee:

a) Value of DD/TR:
b) No. & Name of the issuing bank:

9. Port of Registration (for import purpose): ....................

10. Names of Export Products and their Inputs, alongwith option for supporting manufacturer entitlement details

[Deleted - Goods (i.e. inputs and / capital goods) allowed to be imported under this scheme shall have a broad nexus with the products exported. ]

Sr. No.	Name, Address, PAN Number, Phone No. of Supporting Manufacturer / Associate Manufacturer [Deleted - / job worker ]	Export Product	Names of Inputs (for each export product)
1		1	a
			b
		2	a
			b
			c
			d
			e
2		1	a
			b
			c

(In above Sl. No. 10, second sentence and the words "/job worker" at column 2 has been deleted vide PN NO. 113/2007, DT. 15/02/2008)

10A: Listing of Job-Worker(s) for the purpose of conversion of permitted imports into possible resultant products, when imports are made for ‘own use’.

Note: The beneficiary status holder (Manufacturer Exporter or Merchant Exporter) can utilize full value of duty credit scrip issued to him for his ‘own use’. Beneficiary may decide to make any possible resultant product for utilizing the imports permitted under the Scheme, when imported for ‘own use’. Job-Workers can be used for conversion of imports permitted under the scheme into any possible resultant products. Upon conversion in the factory of Job-Worker, the resultant product can be sold in the open market, upon payment of duties as applicable to the resultant product; including to the conversion unit (i.e. job worker). Sale of permitted import products to Job Workers prior to conversion (into any possible resultant products) shall be treated as a violation of AU and Non-transferability conditions, as imports permitted under Target Plus Scheme as per Para 3.7.6 of the Policy (RE2004) are with Actual User Condition and non-transferable (except to listed supporting manufacturers).

Sr. No.	Name (s) of Job Worker (s)	Address of the Factory of Job Worker (s) (where conversion of permitted imports into possible resultant products is proposed to take place)	Annual Capacity of Job Worker (s) (along with proof thereof)
1
2
3
4
5
6
and so on

Official Stamp/Seal	Signature:	:.....................
	Name in Block Letters:	:.....................
	Designation:	:.....................
	Place:	:.....................
	Full Official Address:	:.....................
	Residential Address:	:.....................
	E-Mail address:	:.....................

(Above Sl.No. 10A has been added vide PN NO. 113/2007, DT. 15/02/2008)

[OLD-
10. Option for supporting manufacturer entitlement details

Goods allowed to be imported under this scheme shall have a broad nexus with the product exported and a declaration in this regard shall be made by the applicant in Appendix 17D. For the purpose of import entitlements under this scheme, ‘broad nexus’ would mean goods imported with reference to any of the product groups of the exported goods within the overall value of the entitlement certificate.

Sr. No. of Supporting Manufacturer	Name, Address, PAN Number, Phone No. of Associate Manufacturer / Supporting Manufacturer / job worker	Sr. No of Product Group	Product Groups	FOB Value of Eligible Exports 2004-05
1		1		US$	Rupee
		2
		3
Sub Total
2		1
		2
Sub Total

]

11. DECLARATION CUM UNDERTAKING

I. I/We hereby declare that this application is based on exports made (in free foreign exchange) during the licensing year 2003-04 and 2004-05 and benefit is being claimed in respect of export proceeds realized in conformity with requirement prescribed in Para 3.2.5 (I) of Handbook of Procedures (Vol. 1) 2004-09.

II. I/We further certify that I/We am/are authorized to verify and sign the statement on behalf of the applicant.

III. I/We fully understand that any information furnished in the above statement, 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.

IV. I/We further declare that I/We has/have not applied nor obtained another Target Plus DFCE Entitlement Certificate issued under paragraph 3.7.1 of the Policy based on the exports made (in free foreign exchange) during 2004-05.

V. I/We further declare that I/We shall comply with the provisions of the Foreign Trade Policy/Handbook of Procedure (Vol.1) and the relevant Customs notification while importing the goods under the scheme and subsequent use of the same under actual user condition.

VI. I/We further declare that for calculating the value of exports, the following exports have not been taken into account, namely:

(a) Export of imported goods covered under Para 2.35 of the Foreign Trade Policy or exports made through transshipment.

(b) Export turnover of units operating under SEZ/EOU/EHTP/STPI/ BTP Schemes or products manufactured by them and exported through DTA units.

(c) Deemed exports (even when payments are received in Free Foreign Exchange and payment is made from EEFC account).

(d) Service exports.

(e) Rough, uncut and semi polished diamonds and other precious stones.

(f) Gold, silver, platinum and other precious metals in any form, including plain and studded jewellery.

(g) Export performance made by one exporter on behalf of another exporter.

VII. I/We further declare that export documents are in conformity with requirement prescribed in Para 3.2.5 (I) of Handbook.

VIII. I/We undertake that the export performance has not been transferred to or transferred from any other exporter.

IX. I/We have not applied for/ taken the benefit of Vishesh Krishi Upaj Yojana for the exports for which I am taking benefit under the Target Plus scheme except for calculation of percentage incremental growth.

X. I/We further declare that in respect of capital goods and/or office equipments, a certificate from jurisdictional Deputy Commissioner Central Excise/Assistant Commissioner of Central Excise or an independent Chartered Accountant, as the case may be, shall be produced confirming installation and use of capital goods and/or office equipments in the importer’s factory or premises, within six months from the date of imports or within such extended period as the said Deputy Commissioner of Customs or Assistant Commissioner of Customs may allow.”

Official Stamp /Seal	Signature:	:.....................
	Name in Block Letters:	:.....................
	Designation:	:.....................
	Place:	:.....................
	Full Official Address:	:.....................
	Residential Address:	:.....................
	E-Mail address:	:.....................

NOTES

Note 1: If the applicant is part of a Group Company as defined in Chapter 9 of Foreign Trade Policy, Entitlement will be adjusted in terms of Para 3.7.4 of Foreign Trade Policy. If any of the Star Group Companies show negative growth, necessary adjustment would be made by RLA to retain the last years’ export performance of each individual star export house, out of the export performance of the applicant company of the group. The balance after adjustment would be counted for the export performance of the applicant company for grant of Target Plus Scheme benefits. Illustrative example is given in the following table to clarify the above.

Where Company B is the applicant company and there are only two star export houses in the group. Illustration (Company B is eligible on difference between Adjusted Export Performance for 2004-05 and FOB Value of eligible exports for 2003-04)
Companies in the Group	FOB Value of eligible exports2003-04	FOB Value of eligible exports 2004-05	Adjustment	Export Performance after Adjustment for 2004-05
A	50	10	40	50
B	60	122	-40	82
Total (A + B)	110	132		132
Groups Growth		Positive

Similarly, if export performance after adjustment falls below 72 (i.e. below 20% required minimum incremental growth rate) then the applicant company is not eligible or if the combined performance of all Star Export House companies of the Group falls below 110 then all Star export houses of this group are not eligible.

Note 2: The FOB Value of Export (in free foreign exchange) in US$ and in Indian Rupees for this application has to be taken from Shipping Bill. For export bills in currencies other than US$, the conversion into US$ may be taken by cross conversion on basis of the conversion rate of US $ to Rupee and the conversion rate of other currency (say Euro) to Rupee as notified by the Customs on the date of let exports order of the shipment.

Note 3: For the applicant to be eligible, the annual export turnover in 2004-05 as in Row 1 of Sr. No. 6 of the application should not show a negative growth over previous year (2003-04).

Note 4: Calculating the eligibility

i) The Value of Eligible Export in 2003-04 (previous year) should be greater than or equal to Rs 10 Crores as in Column A of Row 6 of Sr. No. 6.

ii) Minimum Percentage Incremental growth export as in Row 4 of Sr. No. 6 should be greater than or equal to 20%.

Note 5:

The entitlement shall be calculated on the percentage incremental growth in FOB value of exports in the current licensing year over the previous licensing year, as under:
Percentage incremental growth	Duty Credit Entitlement (as a % of the incremental growth)
20% and above but below 25%	5%
25% or above but below 100%	10%
100% and above	15% (of 100%)

Note 6: Incremental growth beyond 100% will not qualify for computation of duty credit entitlement.

[Deleted- Note 7: The export product groups shall be the product groups listed in Row 14 of Sr. No. 6. Miscellaneous would cover the residual product group category. ]

(Row 14 of Sr.No. 6, Note 7 has been deleted and Sr.No. 10 replaced vide PN. NO. 09/2007, DT. 21/06/2007)

Note 8: Applicant can claim the balance entitlement due as per Row 13 of Sr. No 6 of this application by filing a single consolidated supplementary application within 3 months of receipt of last realization as per RBI guidelines. No Late cut will be imposed in such a case.

Note 9: In case exports made under Sr. No. IV of the declaration appended hereto are covered by more than a single category, the applicant may choose to declare such exports in any one of the said categories as reflected in the Sr. No (vii) of the CA certificate.

Note 10: If an applicant is not satisfied with the calculation of entitlement under the DFCE scheme, he may approach the Grievance Redressal Committee at the Ministry of Commerce & Industry. The details are available at http://commerce.nic.in/grc.htm.

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Documents to be enclosed with the application form:

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1. Copy of the status holder certificate valid during 2004-05.

2. Copy of RCMC valid during 2004-05 and valid currently.

3. CA Certificate as per enclosed annexure to Appendix 17D.

4. Statement of Export and Realization (for Eligible Exports) duly certified by the Bankers as per Appendix 22A, consolidated for each Bank. (Can be downloaded from Website www.nic.in/eximpol)

5. Any other Document that may be specified or called for.

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Annexure to Appendix 17D Target Plus Scheme for Status Holders (2004-05)

CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/COMPANY SECRETARY

I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s................. for the licensing period(s) ..... and

hereby certify that:

i) M/s............................... (Name and address of the applicant) who is a Star Export House has made exports in his own name during the licensing years, 2003-04 and 2004-05 as per the details supplied in the details of exports at Sr.No.5, 6 and the benefit is being claimed in respect of export proceeds realized in conformity with requirement prescribed in Para 3.2.5 (I) of Handbook.

The following documents/records have been furnished by the applicant for verification of the export details and have been examined and verified by me/us namely: (Tick whichever is applicable and give details)

a) Export Order, Invoice

b) Bank Realization Certificate/ FIRCs and SDF/GR declaration

c) Shipping Bills

d) Any other document (please specify).

ii) The financial information given in the above statement is in agreement with the relevant register and records; the same has been incorporated in the books of accounts maintained by M/s................... and their subsidiaries; and is also true and correct.

I/We further declare that export documents are in conformity with requirement prescribed in Para 3.2.5 (I) of Handbook. Where goods are procured from a manufacturer, the shipping bill contains the name of the exporter as well as the supporting manufacturer and no other party.

iii) It has been ensured that the information furnished is true and correct in all respect; no part of it is false or misleading and no relevant information has been concealed or withheld;

iv) Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;

v) 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.

vi) I/We have verified that the applicant has received the realization in his own name, as per the statement of exports and realization given below.

Statement of Export for Eligible Exports
Sr. No.	Name of the Exporter as per Shipping Bill	Shipping Bill Number	Date of Exports as per Para 9.12 [OLD- Let Export Date ]	Item Description	Product Groups	FOB Value of Eligible exports in 2004-05 (in US$)
Total

(At Sl. No. vi above, in the table column heading "Let export date" has been modified vide PN NO. 111/2007, DT. 15/02/2008)

vii) I/We have checked the ineligible export categories details which are as under:

Sr. No.	Category	FOB value of Exports (in US $) 2004-05
1	Export of imported goods covered under Para 2.35 of the Foreign Trade Policy or exports made through transshipment.
2	Export turnover of units operating under SEZ/EOU/EHTP/STPI/ BTP Schemes or products manufactured by them and exported through DTA units.
3	Deemed exports (even when payments are received in Free Foreign Exchange and payment is made from EEFC account).
4	Service exports.
5	Rough, uncut and semi polished diamonds and other precious stones.
6	Gold, silver, platinum and other precious metals in any form, including plain and studded jewellery.
7	Export performance made by one exporter on behalf of another exporter.
	Above categories of exports may contain overlapping categories also

Signature.............................
Name:
Address:
Place..........
Tel. No. ............................

Official Stamp/ Seal

Date...........
Regn. No. and Date of the Corporate Membership:..........

(Above Appendix 17D - Application Form for Target Plus Entitlement for Exports Effected During 2004-05, has been replaced vide PUBLIC NOTICE NO. 16/2005, DT. 04/06/2005) ]

[OLD-
APPENDIX 17-D

Application Form for Target Plus Entitlement for Exports Effected During 2004-05

(Please see paragraph 3.7.1 of the Policy and 3.2.5 of the Handbook).

(To See Appendix 17-D Pl. refer PN NO. 70/2004, DT. 07/04/2005)

(Appendix 17D has been vide PN NO. 70/2004, DT. 07/04/2005) ]

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Appendix 17D

APPLICATION FORMAT FOR DFCE SCHEME FOR STATUS HOLDERS 2003-04

Incorporating Notification No. 28 dated 28.01.2004, Public Notice No. 40 dated 28.01.2004; Notification No. 38 dated 21.04.2004 and Public Notice No. 69 dated 07.04.2005 read with Notification No. 06(RE-2005)/2004-2009 dated 04.06.2005 and this Public Notice.

File No.:__________________________________                           Date: _________________

1.	Name and Address	:
2.	I E Code Number	:
3.	Details of Status Certificate
	For the year 2003-‘04 a) Status b) Status Certificate Number c) Date of Issuance d) Valid from e) Valid up to	: Export House                 [ ] Trading House                [ ] Star Trading House         [ ] Super Star Trading House [ ] : : : :
4.	RCMC No. and Date Issued by	: :

5. Details of Group Companies (see Note 1)

Sr.No.	Names of the Group Company	Eligible Export Turnover (Rupees in Cr)		Growth (in %)
		2002-03	2003-04
1
2
3
	Total Group Turnover

6. Calculation of Value of Exports: (see Note 2 to 7)

Sr.No.	Categories	FOB Value of Exports in US$
		2002-‘03 Column A	2003-‘04 Column B
Row 01	Annual Exports Turnover
Row 02	Exports made in categories (i to vii) mentioned at Sr. No. 6 of the declaration appended hereto
Row 03	Exports made in categories mentioned at Sr. No. 7 of the declaration appended hereto
Row 04	Eligible Exports = Row 1-(Row 2 + Row 3)
Row 05	FOB Value of Total Eligible Exports as in Row 4 above (in Rupees)
Row 06	Incremental value of eligible exports made from Row 05 above= Column B of Row 5-Column A of Row 5 (in Rs)
Row 07	Incremental Export Growth Rate of eligible exports made = {[Column B of Row 4-Column A of Row 4] / Column A of Row 4} X 100 (in %)
Row 08	Percentage of FOB realized (for eligible exports made during 2003-04) as per Bank Realization Certificate (in %)
Row 09	Total Duty Free Credit Entitlement for 2003-04 period.= 10% of Row 6 (in Rs)
Row 10	Duty Free Credit Entitlement applied for (on realized basis for eligible exports made) (in Rs)= Row 9 X [(Row 8 X Column B of Row 5) - Column A of Row 5] / Row 6
Row 11	Balance Duty Free Credit Entitlement due (in Rs)= Row 9 - Row 10
Row 12	Value wise details of Product Groups Sr. No. Product Groups FOB Value of Eligible Exports in Rs (2003-04) 1 Engineering   2 Chemicals   3 Plastics   4 Leather & Leather Products   5 Sports Goods   6 Fish & Fish Products   7 Food Products   8 Handicrafts   9 Electronics   10 Textiles   11 Miscellaneous

7. Breakup for the Split–up Duty Free Credit Entitlement, if any, requested for:

Sr.No.	Entitlement	Break-up of the Entitlement for split-up

8. Details of the Application Fee:

Number, Date and Value of DD/TR:
Name of the issuing Bank:

09. Port of Registration (for import purpose):……………………………………………….

10. Option for supporting manufacturer entitlement details

Goods allowed to be imported under this scheme shall have a nexus with the product groups exported and the applicant in this regard makes a declaration in this Appendix. Goods imported against such entitlement certificate shall be used by the supporting manufacturer [Deleted - / job worker ] in proportion to the value wise and product group-wise value of their direct contribution to the entitlement.

Sr. No. of Supporting Manufacturer	Name, Address, PAN Number, Phone No. of Associate Manufacturer / Supporting Manufacturer [Deleted - / job worker ]	Sr. No of Product Groups	Product Groups	FOB Value of Eligible Exports 2003-04
1		1		US$	Rupee
		2
		3
Sub Total
2		1
		2
Sub Total

10A: Listing of Job-Worker(s) for the purpose of conversion of permitted imports into possible resultant products, when imports are made for ‘own use’.

Note: The beneficiary status holder (Manufacturer Exporter or Merchant Exporter) can utilize full value of duty credit scrip issued to him for his ‘own use’. Beneficiary may decide to make any possible resultant product for utilizing the imports permitted under the Scheme, when imported for ‘own use’. Job-Workers can be used for conversion of imports permitted under the scheme into any possible resultant products. Upon conversion in the factory of Job-Worker, the resultant product can be sold in the open market, upon payment of duties as applicable to the resultant product; including to the conversion unit (i.e. job worker). Sale of permitted import products to Job Workers prior to conversion (into any possible resultant products) shall be treated as a violation of AU and Non-transferability conditions, as imports permitted under DFCE for Status Holders Scheme as per Para 3.7.2.1 (vi) of the EXIM Policy (RE2003) are with Actual User Condition and non-transferable (except to listed supporting manufacturers).

Sr. No.	Name (s) of Job Worker (s)	Address of the Factory of Job Worker (s) (where conversion of permitted imports into possible resultant products is proposed to take place)	Annual Capacity of Job Worker (s) (along with proof thereof)
1
2
3
4
5
6
and so on

Official Stamp/Seal	Signature:	:.....................
	Name in Block Letters:	:.....................
	Designation:	:.....................
	Place:	:.....................
	Full Official Address:	:.....................
	Residential Address:	:.....................
	E-Mail address:	:.....................

(In Sl. No. 10, the words "/job worker" in second sentence & at column 2 has been deleted and Sl.No. 10A - added vide PN NO. 112/2007, DT. 15/02/2008)

11. DECLARATION CUM UNDERTAKING

1. I/We hereby declare that this application is based on exports made (in free foreign exchange) during the licensing year 2002-03 and 2003-04 and the benefit is being claimed in respect of export proceeds realized in conformity with requirement prescribed in Para 3.2.6A (I) of Handbook.

2. I/We further certify that I/We am/are authorized to verify and sign the statement on behalf of the applicant.

3. I/We fully understand that any information furnished in the above statement, 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.

4. I/We further declare that I/We has/have not applied or obtained another DFCE Entitlement Certificate for Status Holders issued under paragraph 3.7.2.1(vi) of the Policy based on the exports made (in free foreign exchange) during 2003-04 from any other office of the DGFT.

5. I/We further declare that I/We shall comply with the provisions of the Exim Policy/Handbook of Procedure (Vol.1) and the relevant Customs notifications while importing the goods under the scheme and subsequent use of the same under actual user condition.

6. I/We further declare that for calculating the value of exports for the year 2002-03 and for 2003-04, the following exports have not been taken into account.

i) Re-export of imported goods or exports made through transshipment;

ii) Export turnover of units operating under SEZ/EOU/EHTP/STPI Schemes or products manufactured by them and exported through DTA units;

iii) Deemed exports (even when payments are received in Free Foreign Exchange) and payment from EEFC account;

iv) Service exports;

v) Supplies made by one status holder to another status holder;

vi) Export performance made by one status holder on behalf of other status holder will not be eligible for entitlement under the scheme;

vii) Supplies made or export performance effected by a non-status holder (Merchant exporter/Manufacturer with any export performance in 2003-04) to a status holder if the applicant as well as the non status holder have less than 25 per cent incremental growth over their respective previous years direct export turnover;

viii) The exports made by an applicant within a group and the group to which it belongs has individually less than 25 per cent incremental growth of export;

ix) The incremental growth of exports achieved by us has not been directly or indirectly, obtained by transferring exports of other exporters.

7. I/We declare that the following products and categories of products have not been counted for entitlement under Duty Free Credit Entitlement Scheme for Status Holders:

a) Rough, uncut and semi polished diamonds

b) Gold, silver in any form including plain jewellery thereof

c) Food grains sourced from central pool maintained by FCI

d) Items exported under free shipping bills

8. I/We further declare that export documents are in conformity with requirement prescribed in Para 3.2.6A (I) of Handbook.

9. I/We further undertake that the goods imported under the DFCE to be issued shall have a nexus with the product group exported.

10. I/We further undertake that in respect of capital goods and/or office equipments, a certificate from jurisdictional Deputy Commissioner Central Excise/Assistant Commissioner of Central Excise or an independent Chartered Accountant, as the case may be, shall be produced confirming installation and use of capital goods and/or office equipments in the importer’s factory or premises, within six months from the date of imports or within such extended period as the said Deputy Commissioner of Customs or Assistant Commissioner of Customs may allow.”

[DELETED-
11. All discounts, commission have been excluded for the purpose of calculation of net FOB value of exports. ]

(Above Sl. No. 11 relating to all discounts, commission has been deleted vide PN No. 22/2005, DT. 14/06/2005)

Official Stamp / Seal	Signature:	:.....................
	Name in Block Letters:	:.....................
	Designation:	:.....................
	Place:	:.....................
	Full Official Address:	:.....................
	Residential Address:	:.....................
	E-Mail address:	:.....................

NOTES

Note 1: In case the exports made by an applicant within a group and the group to which it belongs has individually less than 25% incremental growth of export, then these exports shall not be taken into account for the purpose of calculating the value of exports in Sr. No. 6 as per Note 1(viii) of Para 3.7.2.1 sub para (vii) introduced vide Notification No. 28 (RE 03) dated 28.01.2004.

Note 2: The FOB Value of Export (in free foreign exchange) in US$ and in Indian Rupees for this application has to be taken from Shipping Bill. For export bills in currencies other than US$, the conversion into US$ may be taken by cross conversion on basis of the conversion rate of US$ to Rupee and the conversion rate of other currency (say Euro) to Rupee as notified by the Customs on the date of let exports order of the shipment.

Note 3: For the applicant to be eligible, the annual export turnover in 2003-04 as in Row 1 of Sr. No. 6 of the application should not show a negative growth over previous year.

Note 4: In case exports made under Sr. No. 6 and 7 of the declaration appended hereto are covered by more than a single category, the applicant may choose to declare such exports in any one of the said categories and reflect them in Rows 2 or 3 of Sr. No. 6 of this Application form (Appendix 17D) as the case may be and in the Sr. No (vii) of the CA certificate.

Note 5: Applicant can claim the balance entitlement due as per Row 11 of Sr. No 6 of this application by filing a single consolidated supplementary application within 3 months of receipt of last realization as per RBI guidelines. No Late cut will be imposed in such a case.

Note 6: The export product groups shall be the product groups listed in Row 12 of Sr. No. 6. Miscellaneous would cover the residual product group category.

Note 7: If an applicant is not satisfied with the calculation of entitlement under the DFCE scheme, the applicant may approach the Grievance Redressal Committee at the Ministry of Commerce & Industry. The details are available at http://commerce.nic.in/grc.htm

Documents to be enclosed with the application form:

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1. Copy of the status holder certificate.

2. Copy of RCMC valid during 2003-04 and valid currently.

3. CA/ICWA/CS certificate as per enclosed annexure.

4. Statement of Export and Realization (for Eligible Exports) duly certified by the Bankers as per Appendix 22A of Handbook of Procedures Vol. 1 (2004-09), consolidated for each bank. (Can be downloaded from Website www.nic.in/eximpol)

5. Any other Document that may be specified or called for.

Annexure to Appendix 17D - DFCE for Status Holder 2003-04 Scheme

CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/ COMPANY SECRETARY

I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s................. for the licensing period(s) ...…………………………. and hereby certify that:

i) M/s............................... (Name and address of the applicant) who is an Export House/Trading House/Star Trading House/Super Star Trading House have made exports in his own name during the licensing years, 2002-03 and 2003-04 as per the details supplied in the details of exports at Sr. No.5, 6.

The following documents/records have been furnished by the applicant for verification of the export details and have been examined and verified by me/us, namely:

a) Export Order, Invoice

b) Bank Certificate of foreign exchange earning/FIRCs and SDF/GR declaration

c) Shipping Bills

d) Any other document (please specify).

ii) (a). The financial information given in the above statement is in agreement with the relevant register and records; the same has been incorporated in the books of accounts maintained by M/s................... and their subsidiaries; and is also true and correct.

(b). I/We have verified that export documents are in conformity with requirement prescribed in Para 3.2.6A (I) of Handbook. Where goods are procured from a manufacturer, the shipping bill contains the name of the exporter as well as the supporting manufacturer and no other party.

iii) It has been ensured that the information furnished is true and correct in all respect; no part of it is false or misleading and no relevant information has been concealed or withheld;

iv) Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;

v) 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.

vi) I/We have verified that the applicant has received the realization in his own name, as per the statement of exports and realization given below:

Statement of Export for Eligible Exports

Sr. No.	Name of the Exporter as per Shipping Bill	Shipping Bill Number	Date of Exports as per Para 9.12 [OLD- Let Export Date ]	Item Description as per Shipping Bill	Product Group (s)	FOB Value of Eligible exports in 2003-04 (in US$)
Total

(At Sl.No. vi above, in the table column heading "Let export date" has been modified vide PN NO. 111/2007, DT. 15/02/2008)

vii) I/We have checked the ineligible export categories details which are as under:

		Exports (Rs in Cr)2003-04
1	Rough, uncut and semi polished diamonds
2	Gold, silver in any form including plain jewellery thereof
3	Food grains sourced from central pool maintained by FCI
4	Items exported under free shipping bills
5	Re-export of imported goods or exports made through transshipment;
6	Export turnover of units operating under SEZ/EOU/EHTP/STPI Schemes or products manufactured by them and exported through DTA units;
7	Deemed exports (even when payments are received in Free Foreign Exchange) and payment from EEFC account
8	Service exports
9	Supplies made by one status holder to another status holder;
10	Export performance made by one status holder on behalf of other status holder will not be eligible for entitlement under the scheme.
11	Supplies made or export performance effected by a non-status holder (Merchant exporter/ Manufacturer with any export performance in 2003-04) to a status holder if the applicant as well as the non status holder have less than 25 per cent incremental growth over their respective previous years direct export turnover. (Pl. refer Policy Cir. No. 17/2005, DT. 15/07/2005 for clarification regarding to Sl.NO. 11 above - It is necessary that the supplies made or export performance effected by non-status holder to status holder, the non-status holder has to achieve at least 25 per cent incremental growth over their respective previous years direct export turnover so as to make such supplies eligible for the benefits under the scheme. In light of this, it has been decided that to certify the export figures at Sr. No. 11 of the CA certificate, CA/CS/ICWA may rely on the declaration given by such suppliers (for their supplies made or export performance effected), that they have achieved at least 25% per cent incremental growth over their respective previous years direct export turnover.)
	Above categories of exports may contain overlapping categories also

Signature.............................

Name:
Address:
Place:..........
Tel. No.: ............................

Official Stamp/ Seal

Date:...........
Regn. No. and Date of the Corporate Membership:----------------

(Above Appendix 17D - APPLICATION FORMAT FOR DFCE SCHEME FOR STATUS HOLDERS 2003-04, has been replaced vide PUBLIC NOTICE NO. 15/2005, DT. 04/06/2005)

[OLD-
Appendix 17D

APPLICATION FORMAT FOR DFCE SCHEME FOR STATUS HOLDERS 2003-04

Incorporating Notification No.28 dated 28.01.2004, Public Notice no.40 dated 28.01.2004 and Notification No.38 dated 21.04.2004

File No.:_____________________________________________           Date: ______________________

1.	Name and address	: .............................................. ................................................ ................................................
2.	I E Code Number	: ..............................................
3.	Details of Status Certificate For the year 2003-‘04 a) Status b) Status Certificate Number c) Date of Issuance d) Valid from e) Valid upto	: Export House [ ] Trading House [ ] Star Trading House [ ] Super Star Trading House [ ] : .............................................. : .............................................. : .............................................. : ..............................................
4.	RCMC No.and date	: ..............................................

5A. Details of Group Companies

SN	Names of the Group Company	Eligible Export turnover (Rupees in Crores)
		2003-04	2004-05
1
2
3
	Total Group turnover

If the applicant is part of a Group company as defined in Chapter 9 of Foreign Trade Policy, Entitlement will be adjusted in terms of Para 3.7.4 of Foreign Trade Policy.

5B. Details of Exports:

S.No.	Categories	FOB Value of Exports In US $ (Free Foreign Exchange other than US$ should be convertedinto US$ as notified by Customs)
		2002-‘03	2003-‘04
01.	Annual exports turnover
02.	Exports made in categories (i to vii)mentioned at Sr. No.6 of thedeclaration appended hereto
03.	Exports made in categories mentionedat Sr. No.7 of the declarationappended hereto
04.	Third Party Exports not covered by Sr no 8(i) of the declaration
05.	Eligible Exports =1-(2 + 3 + 4)

6. Details of Eligible Exports mentioned in row 5 of Sr. No.5B above:

Category of Exports	Broad Productcategoryof Items exported	2002-’03		2003-‘04		Names & Addressof the Associate Mfr/supporting Mfr/job workeror FactoryAddress of The applicant
		Value in Free Foreign Exchange in US$		Value in Free Foreign Exchange in US$		Factory addresses
		Exports made	FOB re-alized	Export Made	FOB re-alized
(1)	(2)	(3)	(4)	(5)	(6)
A) Direct Exports As manufacturer Exporter or As merchant Exporter tied to Manufacturer (with Documentary Evidence)	1. Engineering
	2. Chemicals
	3. Plastics
	4. Leather and Leather Products
	5. Sports Goods
	6. Fish and Fish Products
	7. Food Products
	8. Handicrafts
	9. Electronics
	10. Textiles
	11. Miscellaneous
	Total
B) Eligible Third Party exports as Declared in 8(i)Of the declaration Appended	ELIGIBLE EXPORTS UNDER THIS CATEGORY
	1. Engineering
	2. Chemicals
	3. Plastics
	4. Leather and Leather Products
	5. Sports Goods
	6. Fish and Fish Products
	7. Food Products
	8. Handicrafts
	9. Electronics
	10. Textiles
	11. Miscellaneous
	Total
C) Grand Total Equals (Total of A + Total of B) above

7(a). Calculation of Duty Free Credit Entitlement:

Eligible Exports made			Export Growth rate (in %) (3)= 100 x {[(2)-(1)]/(1)}**in US $ (3)	Incremental value of exports			Duty free Credit Entitlement(7)= 10% of(5-1)x ex- change rate*** (7)
In 2002-03 (as at row 5 of Table 5B above)	In 2003-04 (as at row Cof Table 6 above)			Incremental exports in value terms 4=(2)-(1) (4)	FOB realized for exports made during 2003-04
					In US $ (5)	In Rs. (6)
US$ (1)	US$ (2)	Rs. *

Notes:
* The exports during 2003-04 should be minimum Rs.25 crore in order to be eligible for DFCE. In order to calculate the value in Rupees, FOB value of eligible exports should be as per shipping bill.
** The growth in % terms should be minimum 25% in US $ terms in order to be eligible for DFCE.
*** To arrive at the Rupee Value, the exchange rate on the date of issuance of DFCE will be taken into account.

7 (c). Total value of DFEC applied for issuance:
Rs............................................................

7 (d). Breakup for the Split–up Duty Free Credit Entitlement, if any, requested for:

Sl.No.	Entitlement	Break-up of the Entitlement for split-up

8. Details of the Application Fee:

a) Number, date and Value of DD/TR:
b) Name of the issuing bank:

9. Port of Registration (for import purpose): ........................................................

	Ineligible Export Category	Exports (crores) 2003-04
1	Rough, uncut and semi polished diamonds
2	Gold, silver in any form including plain jewellery thereof
3	Food grains sourced from central pool maintained by FCI
4	Items exported under free shipping bills
5	Re-export of imported goods or exports made through transshipment;
6	Export turnover of units operating under SEZ/EOU/EHTP/STPI Schemes or products manufactured by them and exported through DTA units;
7	Deemed exports (even when payments are received in Free Foreign Exchange) and payment from EEFC account
8	Service exports
9	Supplies made by one status holder to another status holder;
10	Export performance made by one status holder on behalf of other status holder will not be eligible for entitlement under the scheme.
11	Supplies made or export performance effected by a non-status holder (Merchant exporter/ Manufacturer with any export performance in 2003-04) to a status holder if the applicant as well as the non status holder have less than 25 per cent incremental growth over their respective previous years direct export turnover.
12	Third party exports not covered by the declaration at sr no. 8(i)
	Total exports may contain overlapping categories also

Direct exporter and Supporting manufacturer Entitlement details
(Separate sheet to be submitted for direct exporter and each of the supporting manufacturers) Goods allowed to be imported under this scheme shall have a broad nexus with the products exported and a declaration in this regard shall be made by the applicant in Appendix 17D.

Name--
Address---
PAN Number
Phone No.---

SN	Products exported during 2003-04 (Eligible category products only)	Value of eligible exports		Product wise Duty credit**	Probable related import items***
					1	2	3
		US $	Rupees*X	Rupees Y
1
2
3
4
5
6
7
8
	Total		SX

* For Rupee Value use the FOB Value as per shipping bill.
** Product wise Duty credit to be computed by the following formula:

Yi= (Xi* Value of the total DFCE Entitlement) / SX

*** For more than 3 items, add columns or list.
DECLARATION
(Undertaking to be given by the applicant)
1. I/We hereby declare that this application is based on exports earning in free foreign exchange during the licensing year 2002-03 and 2003-04 and the benefit is being claimed in respect of export proceeds realized directly from the buyer only in our name and not in joint names.
2. I/We further certify that I/We am/are authorized to verify and sign the statement on behalf of the applicant.
3. I/We fully understand that any information furnished in the above statement, 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.
4. I/We further declare that I/We has/have not applied or obtained another Duty Entitlement Certificate issued under paragraph 3.7.2.1(vi) of the Policy based on the exports in free foreign exchange during 2002-03 and 2003-04 from any other office of the DGFT.
5. I/We further declare that I/We shall comply with the provisions of the Exim Policy/Handbook of Procedure (Vol.1) and the relevant Customs notifications while importing the goods under the scheme and subsequent use of the same under actual user condition.
6. I/We further declare that for calculating the value of exports for the year 2002-03 exports under Sr. No.(i to iv) mentioned below and for 2003-04, the exports under Sr. No.(i to viii) below have not been taken into account.
(i) Re-export of imported goods or exports made through transshipment;
(ii) Export turnover of units operating under SEZ/EOU/EHTP/STPI Schemes or products manufactured by them and exported through DTA units;
(iii) Deemed exports (even when payments are received in Free Foreign Exchange) and payment from EEFC account;
(iv) Service exports;
(v) Supplies made by one status holder to another status holder;
(vi) Export performance made by one status holder on behalf of other status holder will not be eligible for entitlement under the scheme;
(vii) Supplies made or export performance effected by a non-status holder (Merchant exporter/Manufacturer with any export performance in 2003-04) to a status holder if the applicant as well as the non status holder have less than 25 per cent incremental growth over their respective previous years direct export turnover;
(viii) The exports made by an applicant within a group and the group to which it belongs has individually less than 25 per cent incremental growth of export;
(ix) The incremental growth of exports achieved by us has not been directly or indirectly, obtained by transferring exports of other exporters.
7. I/We declare that the following items have not been taken into account for computation of entitlement and export performance under Duty Free Credit Entitlement Scheme for Status Holders:
a. Rough, uncut and semi polished diamonds
b. Gold, silver in any form including plain jewellery thereof
c. Food grains sourced from central pool maintained by FCI
d. Items exported under free shipping bills
8. (i) I/We further declare that in case of third party exports, Export Order, Invoice, GR form, Bank Realization Certificate do not contain 2 names and are in name the of the applicant only;
(ii) Where goods are procured from a manufacturer, the shipping bill should contain the name of the exporter as well as the supporting manufacturer and no other party.
9. I/We further undertake that the goods imported under the DFCE to be issued shall have a Quantity and product nexus with the products exported.
10. I/We further undertake that in respect of capital goods and/or office equipments, a certificate from jurisdictional Deputy Commissioner Central Excise/Assistant Commissioner of Central Excise or an independent Chartered Accountant, as the case may be, shall be produced confirming installation and use of capital goods and/or office equipments in the importer’s factory or premises, within six months from the date of imports or within such extended period as the said Deputy Commissioner of Customs or Assistant Commissioner of Customs may allow.”
11. All discounts, commission have been excluded for the purpose of calculation of net FOB value of exports.

Signature:...........................
Name in Block Letters:............................
Designation:............................
Place:............................
Full Official Address:...............................
Residential Address:...........................
E-Mail address:...........................
Official

Stamp/Seal

NOTE

If an applicant is not satisfied with the calculation of entitlement under the DFCE scheme, he may approach the Grievance Redressal Committee at the Ministry of Commerce & Industry. The details are available at http://commerce.nic.in/grc.htm

CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/ COMPANY SECRETARY
I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s................. for the licensing period(s) ..... and hereby certify that:
i) M/s............................... (Name and address of the applicant) who is a Export House/Trading House/Star Trading House/Super Star Trading House have earned foreign exchange in their own name during the licensing years, 2002-03 and 2003-04 as per the details supplied in the details of exports at Sl.No.5, 6.
The following documents/records have been furnished by the applicant for verification of the export details and have been examined and verified by me/us namely:
a) Export Order, Invoice
b) Bank Certificate of foreign exchange earning/FIRCs and GR declaration
c) Shipping Bills
d) Any other document (please specify).
ii) (a). The financial information given in the above statement is in agreement with the relevant register and records; the same has been incorporated in the books of accounts maintained by M/s................... and their subsidiaries; and is also true and correct.
(b). I/We have verified that in case of third party exports, Export Order, Invoice, GR form, Bank Realization Certificate do not contain 2 names and are in the name of the applicant only . Where goods are procured from a manufacturer, the shipping bill contains the name of the exporter as well as the supporting manufacturer and no other party.
iii) It has been ensured that the information furnished is true and correct in all respect; no part of it is false or misleading and no relevant information has been concealed or withheld;
iv) Neither I, nor any of my partners is a partner, director, or an employee of the above-named entity or its associated concerns;
v) 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.
vi) I have verified the direct export turnover figures of supporting manufacturers/ job worker as well as companies/firms on whose behalf exports have been made by applicant as third party as indicated in Annexure 1 and Annexure 2.
(* Strike out whichever are not applicable)
Signature.............................
Place..........

Tel.No. ............................

Official          
Stamp/ Seal       

Date...........
Regn. No. and Date of the
Corporate Membership..........

---

Documents to be enclosed with the application form:

---

1. Copy of the status holder certificate.
2. Copy of the balance sheet filed with Income Tax Authorities for the relevant year and CA certificate.
3. Self certified copies of shipping bills for direct and third party exports for the year 2003-04 and a statement of exports in the following format.

Name of the Direct /third party exporter	SB number	Let export date	Item description	FOB value	Date of realization of Money

4. Any other Document that may be specified or called for.
(Appendix 17D has been replaced vide PN NO. 69/2004, DT. 07/04/2005) ]
[OLD-
APPENDIX 17-D
APPLICATION FORM FOR TARGET PLUS SCHEME
The Appendix would be notified in due course ]

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