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Application Form for Issuance of EPCG Authorisation

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..... Are you MSME? (if Yes, Pl attach proof) O Yes O No If manufacturer, please select sector classification of export items for which EPCG authorisation is applied for: 1. Engineering Products 2. Electronic Products 3. Drugs and Pharmaceuticals 4. Chemical and Allied Products 5. Apparel and Ready Made Garments 6 Made ups and Home decor items 7. Fabrics 8. Textile accessories 9. Yarns 10. Fish, marine and Meat Products 11. Agriculture and Processed Foods of Agriculture 12. Handicrafts Products 13. Leather Products 14. Plastic Products 15. Sports Goods 16. Gem and Jewellery Products 17. Other If Service Provider, please select sector classification of service rendered for which EPCG authorisation is applied for: 1. Hospitality Sector (including Tourism) 2. Healthcare sector 3. Port handling Service 4. R D services 5. Engineering Services 6. IT ITES 7.Other 2. RC .....

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..... on MSME/LOI/IL/IEM Registration Issuing authority, (if applicable) Factory Addresses 6. Products to be exported/services to be rendered S.No. S.No. of Item Export Type ITC(HS) Code/ Service Code Products to be exported /services to be rendered Technical specification for product Whether product to be exported is restricted for export 7. Details of Capital Goods sought to be imported Currency of Imports Freely convertible currency Postal address of the jurisdictional Central Excise/GST Authority in whose jurisdiction factory/premises of t .....

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..... Primary use of Capital Goods sought to be imported** * Whether Capital Goods/Spares/Tools/Jigs/Fixtures/Dies/Moulds/Spare refractories/Catalyst/computer software systems (specify if any other) ** Whether used for Pre-production activity/Production activity/Post-production activity/for rendering services 8. Indigenous Details IEC of Supplier Name of the Supplier Firm Address of the Supplier Jurisdictional DGFT RA of the Supplier Supplier Letter Type Total CIF value of Imports invalidated (In INR) Total CIF value of Imports invalidated (In US$) Total CIF value of Imports invalidated (In currency of imports) Total CIF value of Imports invalidated (In FCC) Total Notional Du .....

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..... tenance of average export obligation Early fulfillment of EO I have validated the submitted application for any errors. Attachment Details Attachment Type Remark Attachment Name CA/CE Details Sl. No. Application Number CA/CE Membership Number Appendix Type 12. Declaration/Undertaking I /we, hereby, declare/certify that : 1. The particulars and the statements made in this application are true and correct to the best of my/our knowledge and belief and nothing has been concealed or held therefrom. If anything is found incorrect or false it will render me/us liable for any penal action or othe .....

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..... y. You have ticked the box as acceptance of declaration/ undertaking details. Place Date Name Designation Email Mobile Office Address Residential Address GUIDELINES FOR APPLICANTS 1. Application shall be filed online using digital signatures. 2. Applicant shall upload the documents as per details given below: a. Self-certified copy of MSME/IEM/LOI/IL in case of products and GST Registration in case of Service Providers. b. In such cases RCMC from EPC concerned will suffice). c. Certificate from a Chartered Engineer in the format given in Appendix 5A. d. Certificate of Chartered Accountant / Cost Accountant /Company Secretary in Appendix 5B. e. In case of Import of spares, tools, refractories and catalyst for existing plant and machinery, a list of plant/machinery already installed in the factory/premises of the applicant firm/supporting manufacturer for whi .....

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