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APPLICATION FOR CLAIM OF TED REFUND / DUTY DRAWBACK / BRAND RATE FIXATION

DGFT - ANF-7A - ANF-7A (Please tick whichever is applicable) (Application shall be filed online once the software is ready) 1. IEC No Branch Code: 2. Applicant details: (i) Name of the firm/company (ii) Full address (iii) Contact Number (iv) E-mail address 3. Bank s details: (i) Name of the Bank (ii) Address of the Bank (iii) IFSC code (iv) Nature of account(SA/CA) (v) A/c Number (vi) Telephone / Fax No. 4. Excise Authority details: (i) Excise Registration No (ii) Address of the jurisdictional C .....

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refund on TED Sl. No. Inv. No. Date of Description of item(s) of supply Quantity Quantum of TED Late cut, if any Net claim Supply Payment (Provision to be made to add multiple invoices) 9. If the application is for drawback as per Col. A of AIR under drawback schedule: Sl. No. Invoice No. Date of Description of item(s) of supply Tariff No. FOR value Net quantity of supplies Drawback Rate Value Cap(if any Amount of DBK Late cut, if any Net payable amount Supply Payment (Provision to add multiple .....

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as issued. ] 12. Whether claim is made within the prescribed time 13. If not, rate of late cut as per Para 9.02 of HBP 14. If claim for refund of TED is made by supplier: Whether CENVAT credit has been availed by recipient? 15. If claim for refund of TED is made by recipient: Whether CENVAT credit has been availed by him? 16. If claim for duty drawback is made by supplier: Whether CENVAT credit has been availed by him 17. If claim for duty drawback is made by recipient of goods: Whether CENVAT c .....

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m stock/ out sourced locally: 3. Indian origin inputs/components procured locally: 4. Indian origin inputs/components used from stock or procured locally: 21. DBK-I Statement SL No Name of the materials/ Components Quality/ Technical Charachteristics Whether imported/ indigenous Unit Gross Quantity required Wastage Quantity Sale Price of waste per unit of Qty By Product/ co-product Net wt. of the material Remarks Irrecoverable Recoverable Qty. Sale value per unit 1 2 3 4 5 6 7 8 9 10 11 12 13 22 .....

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Rate of Duty Is assessment final Total amount of duty paid Remarks 10 11 12 13 14 15 16 ** Only inputs which were imported/ procured and consumed during the period commencing 90 days prior to the date of supply(s) shall only be taken into account for such claim. A separate work sheet as per DBK form II, II(A), III and III(A) and certificates attached thereto duly certified by Chief Executive/production in-charge shall be submitted, as given in the APPENDIX-7E. 23. Check List of documents to be a .....

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rities or Invoices/statement of Invoices certified by Jurisdictional Central Excise Authority of recipient. (2) In case supply of goods to EOU, ARE-3 duly certified by the recipient and their jurisdictional Central Excise Authority. (3) Self certified copy of B/Es (4) Proof of payment through e-BRC as per APPENDIX-2U or Payment Certificate issued by Project Authority in APPENDIX-7D in original, as the case may be. (5) PAC issued by the Project Authority in original as per APPENDIX-7C or File No. .....

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the resultant product by the supplier of goods as per ANNEXURE-II (in case claim for drawback). (9) Declaration/disclaimer certificate from supplier, in case claim is filed by recipient of goods and from recipient of goods, if claim is filed by supplier of goods, as per ANNEXURE-III. (10) Statement of supplies for Fixation of Drawback Rate as per APPENDIX-7E. DECLARATION / UNDERTAKING 1. I/We hereby declare that the particulars and the statements made in this application are true and correct to .....

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ter of right and I/we shall immediately refund the amount of TED/drawback obtained by us in excess of any amount/rate which may be re-determined by concerned RA / DGFT/Government as a result of post verification/Audit objection or otherwise. 4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI. 5. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company, as the case m .....

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the recipient of goods. 8. I/we further declared that no CENVAT credit facility has been availed on inputs for which drawback claim is made. 9. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.06 of the FTP. Place: Signature of the Applicant Date: Name Designation Official Address Telephone Residential Address Email Address ANNEXURE-I DECLARATION FOR CLAIMING BENEFIT OF TERMINAL EXCISE DUTY (TED) It is certified that no CENVAT credit under the Central .....

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ied the following goods to M/s….. (Name and address of the recipient): S. No. Inv. No. & date Description of goods Unit Qty. Value 2. We are the manufacturer exporters/suppliers and are registered/not registered with Central Excise Authority and have not availed and will not avail CENVAT credit facility in respect of duty paid on inputs/components and/or tax paid on input services, in aforesaid supplies. We have also not availed and will not avail rebate on the duty paid on inputs/com .....

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-mail Address Fax No. Note: Declaration is to be given on letter head of the supplier. The Declaration furnished by the supplier to Office of the Development Commissioner or RA of DGFT should be in duplicate with complete address of the Jurisdictional Assistant/Deputy Commissioner of the Central Excise Division. The Development Commissioner/RA of DGFT would forward the second copy of this Declaration, duly stamped, to the addressed Assistant /Deputy Commissioner of the Central Excise Division fo .....

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