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APPLICATION FORM FOR EXPORT OF SCOMET ITEMS LISTED IN APPENDIX 3 TO SCHEDULE 2 OF ITC (HS) CLASSIFICATION OF EXPORT AND IMPORT ITEMS

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..... Country Code Area Code Tel. No. (2) v. Fax No. Country Code Area Code Fax No. .....

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..... ii. Port of Discharge iii. Country to which item to be exported iv. Ultimate Destination Country 5. Purpose of Export (please tick and give clarification if any): Trade Sample Display/Exhibition 6A. Foreign Buyer Details: i. Name ii. Address Flat/Plot/Block No. Street/Area/Loca lity City Country Postal Code iii. Telephone No. (1) Country Code Area Code Tel .No. .....

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..... v. Fax No. Country Code Area Code Fax No. vi. E-mail 6C. End User Details :(If same as Foreign Buyer and /or Consignee write Same as in 6A and/or 6B as the case maybe) i. Name ii. Address Flat/Plot/Block No. .....

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..... City Country Postal Code ii. SWIFT Code: iii. IBANK B. In India i. Name of the Bank ii. Address of the Bank Flat/Plot/Block No. .....

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..... . Submitted to which Regional Authority iv. File Number Date of Issue iv. Application Fee submission details viz. Amount in Rupees, Demand Draft No./Electronic Fund Transfer No. and Date and the name branch of the bank on which drawn 11B. Jurisdictional Regional Authority: DECLARATION / UNDERTAKING 1. I/We hereby certify that: (i) I/We hereby declare that 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 there from. (ii) I/We fully understand that any information furnished in the application if found incorrect or false will render me / us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. (iii) I/We undertake to abide by the provisions of the FT (D R) Act, 1992, as amended, the Rules and Orders framed there under, FTP, HBP, Appendices and Aayat Niryat Forms and ITC (HS). (iv) I/ We hereby certify that: A. The entity for whom the applica .....

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..... ame Designation Official Address Flat/Plot/Block No. Street/Area/Locality City State PIN Code Telephone Country Code Area Code Tel.No. Place: Date: .....

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..... ferent from the End User. (ii) The Consignee, if different from the Foreign Buyer End User. (iii) Other intermediary /ies, If any (iv) End User Certificates from Foreign Buyer, Consignee and End User must reflect the logical flow of items. (v) Each EUC must mention details of items (including technical specifications) as in Col. 2 of the application (ANF10A), duly matching with the same as in Purchase Order. (vi) 1(one) original End Use-cum-End User Certificate covering the entire item(s) applied for, only from each of the entities in supply chain i.e., Foreign Buyer, Consignee/intermediary (ies) and End User is to be filed. 5. Details of the item(s) given in AND 10A, End User Certificate(s) and Purchase Order(s)must match completely. 6. While filling ANF 10A, care should be taken to ensure the following:- (i) Category of the items proposed to be exported as per Appendix 3 of ITC (HS) Classifications of Export and Import Items should be clearly mentioned. (ii) Port of discharge and route must be clearly defined. Route/mode of transport cannot be changed after export license has been issued. (iii) Against column 6A, 6B 6C, complete address should be .....

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