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Application Form for Service Exports From India Scheme(SEIS)

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..... para 3.08 (f) of FTP) iii Name of the firm iv Address iv Telephone No vi Email ID 2. RCMC Details : i. RCMC Number ii. Valid upto [dd-mm-yyyy] -- -- iii. Issuing Authority iv. Products / Services for which registered - in terms of main line of business 3. Frequency of Application Annual 4. Invoice-wise details of N .....

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..... Total as per Annexure C Total NFE Total Entitlement in USD (1) For period 01.11.2017 to 31.03.2018 (Period 2) 1 2 Total as per Annexure C Total NFE Total Entitlement in USD (1) Total Entitlement in USD (2) Guidelines for filling the Table above: 1) If the Total NFE in USD in Col. No. 7 of the Table above exceeds the minimum earnings criteria prescribed at para .....

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..... 17 and 18-19 figures in Rs based on table as in Sl.no. 4 and 6 above 10 Rate of Late Cut, if any 11. Late Cut Deduction amount in Rs. 12. Final Entitlement (9-11) in Rs 13 Port of Registration (for purpose of imports): 14 Number of Certificates required, if any, (in multiples of Rs. 5.00 lakhs each) - (please note that in case two scrips are required, the number of split is 1) DECLARATION/UNDERTAKING 1 I/ We hereby certify that : A. the entity for whom the application has been made have not been penalized/ have been penalized (please cut across in applicable portion) under any of the following Acts (as amended from time to time) in the last five years: (i) The Customs Act, 1962, (ii) The Central Excise Act 1944, (iii) Foreign Trade (Development Regulation) Act 1992, (iv) The Foreign Exchange Management Act, 1999; and (v) The Conservation of Foreign Exchange, Prevention of Smuggling Activities Act, 1974 (vi) The GST Acts (vii) SEZ Acts and Rules .....

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..... by certify that that particulars and statements made in this application are true and correct and nothing has been concealed or held there ANF 3B from. I/We fully understand that any information furnished in the application if found incorrect or false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. In case of ineligible claim/ over claim, I shall be under obligation to refund the ineligible claim/ overclaim in electronic model any other permitted mode of payment with interest at the rate with interest at the rate prescribed under section 28AA of the Customs Act 1962, from the date of issue of scrip in the relevant Head of Account of Customs within one month. I understand that I shall also be under obligation to surrender the scrip whether partially utilized or fully unutilized, at any stage, if asked to do so by the DGFT. 11. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph, 9.06 of the Foreign Trade Policy. 12. In case the entity for whom the application has been made have been penalized as per the declaration (1) above, the details of such penal .....

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..... ign Exchange, by the IEC holder, relating to service sector in the Financial year have been examined and verified by me. 3. Services for which benefit is claimed do not include ineligible services and remittances as per the FTP and HBP 2015-20, Policy circulars and Trade Notices as published from time to time. 4. Neither I, nor any of my / our partners is a partner, director, or an employee of above-named entity, its Group companies or its associated concerns. 5. Details of Foreign Exchange Earned for Supply of Service From India to outside India or in India, and Total expenses /payment/remittances of Foreign Exchange by the IEC holder, relating to service sector in the Financial year is as under the Table 1 below. 6. I have verified the information in the SI no. 6 to 12 of the ANF 3B, filled by the applicant and have found them to be correct 7. I hereby declare that I have correlated all the Invoices mentioned in Annexure B of this certificate with the corresponding proof of remittance and foun .....

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..... .. Total NFE Total Entitlement in USD (A) For period 01.11.2017 to 31.03.2018 (Period 2) 1 2 Total NFE Total Entitlement in USD (B) Total Entitlement in USD .....

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..... der the relevant entry in the Appendix 3D/3E. 1 2 Annexure B Sl.No. Invoice No. Date of Invoice Provisional CPC Code as per Appendix 3D Corresponding FIRC/ e FIRC No./ Bank Certificate Value in USD/ INR as per Invoice 1 2 Annexure-C Calculation of Total expenses / payment / remittances in the financial year: Sl.No. Invoice No. and date .....

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