APPLICATION PERFORMA FOR CERTIFICATION OF EXPORT PERFORMANCE OF UNITS IN AGRO CHEMICALS SECTORS BY THE REGIONAL OFFICES OF THE DGFT AS PER CUSTOMS NOTIFICATION NO 12/2012 dated 17.3.2012

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..... AGRO CHEMICALS SECTORS BY THE REGIONAL OFFICES OF THE DGFT AS PER CUSTOMS NOTIFICATION NO 12/2012 dated 17.3.2012 1. Name and Address of the Applicant 2. IEC Number 3. Details of exports and import entitlement Preceding licensing year s physical exports (in Rscrores) Entitlement @ 1% of the FOB value of physical exports Cumulative i .....

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..... le Notification no. 21/2002 dated 1.3.2002 . ) will not exceed 1% of the FOB value of exports in the financial year c. We/I hereby undertake that the imported goods would be installed in the factory of the importer within 6 months of the date of importation. These goods would not be transferred or sold for a period of 7 years from the date of installation. d. We/I hereby declare that the .....

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..... Signature of the Proprietor/Director(s)/ Partner(s) Designation E-mail id:- Phone No.:- Residential Address:- Date: Place: CHARTERED ACCOUNTANT S CERTIFICATE/COST ACCOUNTANT S CERTIFICATE This is to certify that I have verified the details furnished by the unit as at S.Nos 1 to 3 along with the Declaration/ Undertaking given by the Proprietor/ Partner/ Di .....

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