ANF 5C
(For EO Re-fixation under EPCG Scheme)
Part A
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1. Applicant Details |
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IEC Number |
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Branch Code |
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Name |
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Address |
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Telephone No |
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Email ID |
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2. Application Details |
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Application For |
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Ecom. Reference No |
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Submission Date |
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Submitted To |
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RLA File No |
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RLA File Date |
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3. RCMC Details |
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i. RCMC Number |
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ii. Date of Issue |
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iii. Issuing Authority |
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iv. valid upto |
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Products for which registered |
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4. Type of Exporter (please tick) ( √ ) |
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i. Government Undertaking |
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ii. Public Limited |
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iii. Private Limited |
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iv. Proprietorship |
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v. Partnership |
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vi. Others |
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5. Nature of Concern (please tick) ( √ ) |
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i. Merchant Exporter |
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ii. Manufacturer Exporter |
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iii. Service Provider |
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iv. Others (please specify) |
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v. Merchant cum Manufacturer |
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6. Industrial Registration Details |
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i. SSI / IEM / LOI or IL Registration Number |
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ii. Date of Issue |
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iii. Issuing Authority |
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iv. Products for which registered |
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7. Excise Details (For those registered with Central Excise Authority) |
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i. Excise Registration Number |
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ii. Issuing Authority |
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8. Status House Details: |
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i. EH / SEH / TH / STH / PTH |
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ii. Certificate Number |
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iii. Date of Issue |
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iv. Issuing Authority |
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v. Valid Upto |
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Part B
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9. |
Block year of Export Obligation fulfilment |
1st year [ ]
5th year [ ]
9th year [ ] |
2nd year [ ]
6th year [ ]
10th year [ ] |
3rd year [ ]
7th year [ ]
11th year [ ] |
4th year [ ]
8th year [ ]
12th year [ ] |
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10. |
Export mandated under the block prescribed in row above |
As a percentage of total exports to be made. |
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11. |
Export actually made |
As a percentage of total exports to be made. |
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12. |
Details of EPCG Authorization presented for re-fixation of export obligation: |
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S. No. |
EPCG Authorization No. |
Date of Issue |
Export Product(s) |
Capital Goods applied for import |
Export Obligation fixed as per import made (in US $) |
Exports actually made (in US $) |
% of export unfulfilled |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
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Cif Value of Imports (in US $)
(9) |
Total Customs Duty Saved
(10)
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Re-fixed Export Obligation
(11) |
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Basic (A) |
Additional/CVD (B) |
Others (SAD.ETC if applicable) (C) |
Rate of Duty levied on import (D) |
Total Duty saved (A+B+C+D) |
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=8* (10)*(8)/100 for cases where refixation application is made within 2 years from the date of issue of EPCG Authorization.
=2*(10)*(8)/100 for cases where the remaining EO is less than 2 years on the date of application for refixation. |
DECLARATION/ UNDERTAKING
1. I/We hereby declare that the particulars and the statements made in this application for refixation of export obligation are true and correct to the best of my/our knowledge and belief and nothing has been concealed or held the refrom and if proved incorrect of false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.
2. I/We further declare that the re-fixation of export obligation is being sought for the EPCG authorization where atleast 50% of the exports indicated in row 6 above have been realized.
3. That I/We shall be liable to penal action in accordance with the Policy/Procedure/Foreign Trade addition to forfeiture of bank Guarantee or any other Bond/Guarantee given to the Customs/ licensing authority, in the event of failure to fulfil the export obligation as stipulated, within the export obligation period prescribed or subsequently extended by the competent authority.
4. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.9 of the Policy.
Place
Date |
Signature of the Applicant
Name
Designation
Official Address
Residential Address
Email:
Telephone No.(O): |
GUIDELINES FOR APPLICANTS
1. Two copies of the application must be submitted unless otherwise mentioned.
2. Each individual page of the application has to be signed by the applicant.
3. Application must be accompanied by EPCG authorization in original.
Note: 1. Please see paragraph 5.5(i) of the Policy and paragraph 5.19 of the Handbook (Vol.I).
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