APPENDIX - 23

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PROFORMA FOR SUBMISSION OF GRIEVANCE REPRESENTATION

                                                                                                       
File No.:-------------------------------- 				Date:---------------------------


1.	Name of the Applicant			:...................................
2.	Address:					:...................................
	Telephone No:				:...................................
	E-Mail address				:...................................
	Fax:					:...................................

3.	Grievance pertains to: 			Details may be mentioned (use additional 
	(Please tick)				sheets, if required)

	EPCG Scheme  				:...................................
	Duty Exemption/Remission Scheme		:...................................
	Diamond Gem & jewellery & jewellery Scheme	:...................................
	Export Licence				:...................................
	Import Licence				:...................................
	Any other matter				:...................................

4. 	Particulars of file/ correspondence Ref No./	:...................................
	date of DGFT or its regional office, if any:	

5	Whether the Grievance  Committee of the	:................................... 
	concerned  regional  licensing  office  has 
	been   approached  and,  if   so, furnish 
	particulars/ decision, if any, taken by 
	such a Committee.	

6.	Any other remarks/point that you may 	:...................................
	wish to state: 	


                                       					Signature

                                        					Name in Block Letters :................

                                        					Designation : ............................

                                        					Telephone : ..............................