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APPLICATION FOR FREE SALE & COMMERCE CERTIFICATE

APPENDIX 39 - Old_Provisions - Appendix - Foreign Trade Procedure (RE - 2012) / 2009-14 (From 5-6-2012 to 31-3-2015) - APPENDIX 39 - APPENDIX 39 APPLICATION FOR FREE SALE & COMMERCE CERTIFICATE 1. Name of the firm / Company : 2. Address of Registered Office : (i) Tel No : (ii) Fax No : (iii) e.mail ID 3. Importer Exporter Code No : (i) Code No. (ii) Name & Address of issuing authority 4. Registration -cum-Membership Certificate (RCMC) details (i) Name of the Council (ii) Registration No .....

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re not prohibited or restricted for export under Schedule 2 of ITC (HS) and are free for export; (ii) all the items listed in Annexure A have usage in hospitals, nursing homes and clinics, for medical and surgical purposes; (iii) all the items listed above are not covered under Drugs & Cosmetics Act, 1940. (Signature) Name & Designation of the Authorized Signatory Seal of the Company DECLARATION / UNDERTAKING 1. I / We hereby declare that the particulars and the statements made in this a .....

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and ITC (HS). 4. a. I / We hereby certify that the firm / company for whom the application has been made has not been penalized under Customs Act, Excise Act, FT (D & R) Act 1992 and FERA / FEMA. b. I / We hereby certify that none of the Proprietor / Partner(s) / Director(s) / Karta / Trustee of firm / company, as the case may be, is / are a Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / Company which has come to adverse notice of DGFT. c. I / We hereby certify t .....

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ort under any of the provisions of the Policy. 5. I / We hereby declare that I / We have not obtained nor applied for such benefits (including issuance of an Importer Exporter Code Number) in the name of our Registered / Head Office or any of our Branch(s) / Unit(s) / Division(s) to any other Regional Authority. 6. I / We hereby declare that I/we have perused the list of SCOMET items as contained in the Appendix 3 to the Schedule 2 of the ITC (HS) and that the item(s) exported / proposed to be e .....

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e provisions of Para 2.67 and Para 2.67.1 of the HBP v1. 8. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.9 of the Policy. Place Date Signature of the Applicant Name Designation Official Address Telephone Residential Address Email Address Note: 1. This form with Annexure -A may be submitted without other parts of the Aayat Niryat Form. 2 .For items falling under the Drug & Cosmetics Act, 1940, application for issue of Free Sale & Commerce Ce .....

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