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Shipping Bill For Export Of Goods Under Claim For Duty Drawback

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..... Consignment Export [ ] Others (Specify) [ ] Port of Loading Nature of Contract : CIF [ ] / CFR [ ] / FOB [ ] Other (Specify) [ ] Port of Discharge Country of Destination Exchange Rate U/S 14 of CA Currency of Invoice S. No. Marks Nos. No. Kind of Pkgs. Container Nos. 2 [Statistical Code, Description of Goods, and EXIM Scheme Code, where applicable] Quantity 2 [Value FOB PMV where applicable] Net Weight Gross Weight Total FOB Value in words Analysis of Export Value Currency Amount Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods. FOB Value Freight .....

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..... trol If export under : Custom House Agent LIC No. Deferred Credit [ ] Joint Ventures [ ] Rupee Credit [ ] Others [ ] RBI s Approval/Cir. No. Date Pre-Carriage by Place of Receipt by Pre-Carrier Type of Shipment : Vessel/Flight No. Rotation No. Outright Sale [ ] Consignment Export [ ] Others (Specify) [ ] Port of Loading Nature of Contract : CIF [ ] / CFR [ ] / FOB [ ] Other (Specify) [ ] Port of Discharge Country of Destination Exchange Rate U/S 14 of CA Currency of Invoice S. No. Marks Nos. No. Kind of Pkgs. Container Nos. 2 [Statistical Code, Description of Goods, and EXIM Scheme Code, where applicable] .....

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..... Address of Bank .... ....... 6. Indent [ ] ..... 7. Acceptance of Contract [ ] .... 8. Letter of Credit [ ] 2. Account No. . 3. DBK Ledger No. ..... 9. QC Certificate [ ] 10. Port Trust Document [ ] 11. Any other (Specify) [ ] Item No. in B/E S. No. Sub S. No. of DBK Schedule Qty./Wt. On which DBK Claimed Value on which DBK claimed Rate of DBK Amount of DBK Excise Customs Excise Customs Total Total Amount in words : Rupees . Signature of Exporter/CHA Duplicate ' .....

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..... : CIF [ ] / CFR [ ] / FOB [ ] Other (Specify) [ ] Port of Discharge Country of Destination Exchange Rate U/S 14 of CA Currency of Invoice S. No. Marks Nos. No. Kind of Pkgs. Container Nos. 2 [Statistical Code, Description of Goods, and EXIM Scheme Code, where applicable] Quantity 2 [Value FOB PMV where applicable] Net Weight Gross Weight Total FOB Value in words Analysis of Export Value Currency Amount Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods. FOB Value Freight Insurance Rate Commission Currency .....

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..... Comptist PRE-RECEIPT FORM Verified that the amount of DBK as claimd above is admissible subject to description found correct on the basis of physical examnination/test etc. Signature of A.O. Stamp Received the sum of Rs. .. as drawback REVENUE STAMP Signature of Exporter/CHA 'LET EXPORT' Signature of Officer of Customs 'ALLOWED FOR DESPATCH' Signature of Officer of Customs Claim Pre-audited for Sanction Claim passed for Rs. Inspector (Audit) Supdt./AC Claim Registration No. ..Issued Cheque No. Dated .....

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..... Amount Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods. FOB Value Freight Insurance Rate Commission Currency Discount Amount . Other Deductions S. No. Export Tariff No. Assessable Value under Sec. 14 of CA Duty Cess Total Duty Cess Duty payment particulars Rate Amount Rate Amount Total Duty/Cess Amount in words : Rupees Collection Stamp Declaration : I/We declare that all particulars given herein are true and correct. I/We also attach the declaration(s) under clause No.(s) .. Public Notice No .....

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