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Exchange Control (Exporters Declaration) (original/duplicate)

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..... o. Date: Mode of Transport: [ ] Air [ ] Land [ ] Sea [ ] Post/Couriers [ ] others Category of Exporter: [ ] Custom (DTA units) [ ] SEZ [ ] Status holder exporters [ ] 100% EOU [ ] Warehouse export [ ] others (Specify)....... .....

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..... Whether payment to be Received through ACU? [ ] Yes [ ] No Let Export order (LEO) Date: General Commodity Description: State of Origin of Goods: Total FOB value in words (INR): Custom Assessable value (INR)*: .....

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..... Insurance Commission Discount Other Deduction .....

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..... aration is made and that the particulars given above are true and that the value to be received from the buyer/third party represents the export value contracted and declared above. I/We undertake that I/we will deliver to the authorised dealer bank named above the foreign exchange representing the full value of the goods exported as above on or before........................ (i.e. within the peri .....

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