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Application Form for Service Exports From India Scheme(SEIS)

DGFT - ANF -3B - ANF -3 B (Kindly read para 3.07 to 3.12 of FTP and Para 3.04 of HBP and other common procedural features applicable to SEIS before filing application) 1. Applicant Details: i IEC No. ii Name iii Address iv Telephone .....

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main line of business 3 Frequency of Application Annual 4 Supply of eligible Service by Service Provider Gross Foreign Exchange earned in US$ Total expenses/ payment/ remittances of Foreign Exchange in US $ Net Foreign Exchange earned in US $ 1 2 3 =(1-2) i. Supply of a service from India to .....

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which are otherwise considered as having been paid for in free foreign exchange by RBI, (As per Total of col. 6 of Annexure- C) (As per Total of col. 6 of Annexure- C) iv Total (As per Total of col. 6 of Annexure D) 5 Sector wise details of Net Foreign Exchange earnedfor eligible services: Sl No Description of service rendered Sl No. of Service as per Appe .....

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Total This will match with amount as at Colmn 1ofSr No 4(iv) This will match with amount as at Colmn2 of Sr No 4(iv ) This will match with amount as at Colmn 3 of Sr No 4(iv ) 6 Exchange rate of US$ to INR as on 1st April of the next financial year .....

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l Number 5 exceeds the minimum earnings criteria prescribed at para 3.08 (b) of FTP, the RA will issue scrip. In case amount in Col. No. 7 of Serial Number 5 is negative, No scrip shall be issued DECLARATION/UNDERTAKING 1 I/We hereby certify that : B. the entity for whom the application has been made have not been penalized under any of the following Acts (as amended from time to time): (i) The Customs Act, 1962, .....

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s/are a Director(s) / Partner(s) / Proprietor / Karta / Trustee in any other Company/ firm / entity which is on the Denied Entity List (DEL) of DGFT; D. neither the Registered Office of the company / Head Office of the firm / nor any of its Branch Office(s)/ Unit(s)/ Division(s) has been declared a defaulter and has otherwise been made ineligible for undertaking import / export under any of the provisions of the Policy; 2 I/We undertake to .....

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ender me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. 4 I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.06 of the Foreign Trade Policy. 5 I hereby certify that foreign exchange earned on account of services rendered from India alone in terms of Para 9.51 (i) and Para 9.51 (ii) of FTP has been taken into account for this application under .....

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Flat/Plot/Block No Street/Area/Locality City State PIN Code Telephone No. Country Code __ Area Code _____ Phone number_______ - - .....

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I have examined prescribed registers and also relevant records of M/s..........................…………………………… having IEC Number……………………... for period ………………… ……….. and certify that: 1. Bills, Invoices, Forward Inward Remittance Certificates (FIRCs), Bank Realization Certificat .....

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Para 3.09 of FTP 2015-20. 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, (as certified in Annexure A to C) and Total expenses /payment/remittances of Foreign Exchange by the IEC holder, relating to service sector in the Financial year ( .....

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a. Para 9.51 (i) of FTP As per Total of col. 6 of Annexure A b. Para 9.51 (ii) of FTP As per Total of col. 6 of Annexure B c. Supply of anotified service, and also appearing in Appendix 3E , in India relating to services where value is realised in Indian Rupees which are otherwise considered as having been paid for in free .....

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l expenses/ payment/ remittances of Foreign Exchange in US $ Net Foreign Exchange earned in US $ 1 2 3 4 5 6 7 Total This will match with amount as at Column 1of Sr No 6 This will match with amount as at Column 2 of Sr No 6 This will match with amount as at Column 3 of Sr No 6 8 .....

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CWA/CS Name of the Signatory Designation Membership No. Official Address Flat/Plot/Block No Street/Area/Locality City State PIN Code Telephone No. Country Co .....

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Place: Date: Annexure-A Calculation of Foreign Exchange Earnings for services covered under per Para 9.51(i) of FTP Sl No. Particulars Date of Transaction Earning in Free foreign Exchange (Amount in Currency of transaction) Exchange rate on the date of transaction to convert in US $ Equivalent in US $ (i.e. 4X5) 1 2 3 .....

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