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See rule 13

Annexure - B - Rule - Customs - Annexure - B - Annexure - B 1. Name and Address of the Exporter /Manufacturer: 2. Registration Number: 3. Country of origin: All cost and price figures are to be shown in US dollars ($) 4. Export Product-wise general information: S. No. Description of the product Model/Brand HS code FOB / ex-works value 5. Product -wise material cost information (to be furnished for each product listed in Para 4 above): A B C D E F G H Sl. no. Description of component, materials, .....

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issuing authority; (iii) non-originating materials used in production. 6. Calculation (i) Value of non-originating materials used in production as a percentage of FOB/ ex-works value:____ (ii) Value of originating materials as a percentage of FOB/ ex-works value:_____ DECLARATION I declare that the information provided by me as above is true and correct. I will permit, as and when required, inspection of our factory/products and undertake to maintain up to date costing records. Signature, Name .....

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