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APPLICATION FORM FOR EXPORT OF SCOMET ITEMS INCLUDING SOFTWARE AND TECHNOLOGY (UNDER GLOBAL AUTHORISATION FOR INTRA COMPANY TRANSFER) LISTED IN APPENDIX 3 TO SCHEDULE 2 OF ITC (HS) CLASSIFICATION

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..... (2) v. Mobile No. Countr Code Area Code Fax No. vi. E-mail address where alerts and notifications to be sent vii. Company Website viii. Principal Business Activities of the applicant firm: ix. Is this applicant a parent company ? Yes No x. If applicant is a subsidiary, then provide following details: Name Address Country of Export (tick the appropriate) a. Parent Company b. Other Subsidiaries (to which export .....

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..... (d) Telephone call transactions If yes, then provide details_________________ ii. Can the user easily change the cryptographic functionality of the item what is specified in the manufacture s specification? Yes No iii. Is the item designed for installation by the user without further substantial support by the supplier? Yes No SECTION C: TECHNICAL QUESTION (leave, if not applicable) Does the item contain the following cryptographic functions? 1. A symmetric algorithm employing a key length in excess of 56 bits, not including parity bits? Yes No If Yes please state the following a) Full name: b) Key Length / bits: c) Is it used for any of the following? i. Authentication ii. Digital Signature iii. Data integrity iv. Non-repudiation v. Digital rights management, including the execution of copy protected software vi. Encryption or decryption support of entertainment, mass commercial broadcasts or medical records management vii. Key management in support of any of the cryptographic functions in above 1. (i) to (vi) d) .....

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..... icense No. Date Details of items exported Quantity exported Country to which exported DGFT s (HQ s) File Number Category Description 5. Shipment Details ( In case of Intangible Transfer of Technology (ITT)) i. Mode of Export Over the counter transactions Mail Order Transactions Electronic transactions Telephone call transactions Others ii. Countries to which item to be exported iii. Ultimate Destination Country 6A. Consignee* Details (If different from ultimate end user) * The DGFT need to be informed in advance in case of any new consignee is involved. i. Name ii. Address Flat/Plot/Block No. Street/Area/Locality City .....

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..... of Indian parent company ☐ Documentary Proof that establishes contractual agreement between foreign parent/subsidiary and/ or Indian parent/subisidiary with the third party involved in the supply chain, wherever applicable. ☐ Relevant Undertakings and Declaration, where applicable ☐ Purchase Order(s)/Contract Agreement(S)/ Copy of Master Service Agreement (MSA)/Warranty Policy Conditions ☐ Export Licence(s) from DGFT, wherever applicable. ☐ Export request Letter, where applicable ☐ Documentary Proof of License Exception granted by the export control licensing authority of country of the foreign parent company with validity (wherever applicable) ☐ Export license of foreign country (wherever applicable) ☐ A self-certified copy of the ICP of the foreign parent company being adopted by Indian subsidiary/ self-certified copy of ICP of Indian parent company/ ICP certified by Government like AEO Scheme ☐ Proof of repair obligation in India (Wherever applicable) ☐ Proof of demonstration purpose (wherever applicable) ☐ Other, Please specify . .....

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..... undertaking import I export under any of the provisions of the Policy; D. We have neither obtained nor applied for issuance of an Importer Exporter Code Number in the name of our Registered I Head Office to any other Licensing Authority. (v) I/We hereby declare that I/We have neither obtained nor applied for such benefits (including issuance of an Importer Exporter Code Number) in the name of our Registered I Head Office or any of our Branch(s) Unit(s) Division(s) to any other Regional Authority. (vi) We have complied with the conditions of all previous licences/authorizations issued to us for export of SCOMET items and wherever required have duly intimated the J/o DGFT, New Delhi along with documentary evidence regarding receipt of the items of export by the end-user within the stipulated time. (vii)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 and lTC (HS) and submit all requisite documents to the o/o DGFT (SCOMET Section), failing which 1/We shall liable to action under FT (D R) Act, 1992 as amended or rules and orders made the under, and the Customs Act, 1962. .....

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