APPENDIX - 10C
STATEMENT OF EXPORT/ REDEMPTION FORM UNDER EPCG SCHEME
NOTE: PLEASE SEE
PARAGRAPH 6.12 AND
6.13 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 imposed on the EPCG Licence
i) Export obligation equal to four/five/six
times of the CIF value of capital goods. :
ii) Average exports to be maintained :
e) Product to be exported as per the :
conditions attached to the
EPCG licence.
f) Date of clearance of the first consignment of :
C.G. 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 :
| S.No. | Product Exported | Shipping Bill No./ Date Date of L/C/ ARO | FOB value of exports | Remarks |
| | | | Exports made out of imported capital goods to discharge E.O. imposed on the Licence and export proceeds realised | Exports through third Party as per S/Bill and export proceeds realised | |
| (1) | (2) | (3) | (4a) | (4b) | (5) |
| | | | | | |
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 and 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.
___________________________________________________
Signature with the seal of the Bank
Bank Code No. _____________________________________
Date:
Note:
- 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 showing the date of clearance of the first
consignment;