APPENDIX - 9A
STATEMENT OF EXPORT/ REDEMPTION FORM UNDER EPCG SCHEME
NOTE: PLEASE SEE PARAGRAPH 5.9 AND 5.13 OF THIS HANDBOOK
a) Name & address of the Licence holder :
b) EPCG Licence No. & Date :
c) C.I.F. Value : (i)Issued
: (ii)Utilised
d) Export Obligation w.r.t imports :
effected under the EPCG Licence
i) Export obligation equal to four/five/six :
times of the CIF value of capital goods
as may be the case.
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/Lorry/ Railway receipt number and date | FOB value of exports/ FOR value of supplies | Remarks |
| | | | Exports/ supplies made/ capable of being made out of imported capital goods to discharge E.O. imposed on the Licence and export proceeds realized | |
| | | | Direct exports | Third Party exports | Deemed exports | |
| (1) | (2) | (3) | (4a) | (4b) | (4c) | (5) |
| | | | | | | |
(Second row of column (4) has been corrected vide
PN. No. 12(RE-02), Dt. 2/5/2002)
iv) We further declare that we have made exports of US$/Rupee________ in the licensing year
_________ for maintenance of average (other than that mentioned in iii) above).
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. It is also certified that all the shipping
bills verified by me/us as mentioned in iii) above contained in the EPCG Licence No. and date as given at
Sl.No.b) above.
Signature with seal of the
Chartered Accountant/Cost
& Works Accountant
Membership No.
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.
For Deemed exports Signature with the seal of the Bank
Bank Code No. ______________________________
Date:
- Note:
- 1. The consolidated statement may be submitted only at the time of seeking redemption of Bank Guarantee / Legal Undertaking 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.
(Documents to be enclosed with the application form under Appendix- 9 A has been corrected vide
PN. No. 12(RE-02), Dt. 2/5/2002)