Customs Forms

Declaration to be filed in case of export of goods under claim for drawback

1/we ………………………(name of the exporter) do hereby declare as follows: -

(a) that the quality and specifications of the goods as stated in this shipping bill are in accordance with the terms of the export contract entered into with the buyer / consignee in pursuance of which the goods are being exported;
(b)

that the duties of Customs and Central Excise have been paid in respect of such containers, packing materials or other materials, no separate claim for rebate of duty under Rule 12A or Rule 191A of the central excise rules, 1944 has been made or will be made to the central excise authorities;

(c) that there is no change in the manufacturing formula and in the quantum per unit of the imported materials or components if any, utilised in the manufacture of export goods; and that the materials or components, which have been imported, continue to be so imported and are not being obtained from indigenous sources;
(d) that the present market value of the goods is as follows:-
(e) that the goods are not manufactured and / or exported in discharge of export obligation against an advance licence issued under the Duty Exemption vide relevant import and export policy in force;
(f) that the goods are not manufactured and / or exported by a unit licensed as a 100% export oriented unit in terms of the import and export policy in force;
(g) that the goods are not manufactured and / or exported by a unit situated in any Free Trade Zone / Export Processing Zone or any such other Zone;
(h) that the goods are not manufactured partly or wholly in bonds under section 65 of the Customs Act, 1962;
(i)

that the goods are not manufactured partly or wholly in bond under Rule 191B of the Central Excise Rule, 1944;

(j) that the export value of each of the goods covered by this shipping bill is not less than the total value of all imported materials used in the manufacture of such goods.
 

(Note: Strike out the declaration whichever is not applicable)

Name & Signature of the exporter……………………………………

(for use by the Customs Authorities)

 

Annexure  - II

Declaration to be filed in case of export of goods under the DEEC scheme I / We ………………. (name of the exporter) do hereby declare as follows:-
(a)

that the goods to be exported under this shipping bull are the products corresponding to the export products specified against SL No. ………… in part (e) of the DEEC No. …………. Dated ……….. issued by the joint / Deputy Chief Controller of Imports & Exports (Name of the office);

(b)

that the following raw materials / components / consumables have been used for the manufacture of goods covered under this shipment, namely: -

 

 

  S. No. Description Quality

Technical Characteristics

Quantity

Whether imported / indigenous

(c) that I / We are not availing the benefit of the provisions of Rule 191A or Rule 191B of the Central Excise Rules, 1944.
 

Or

(d)

that I / we are availing the benefit of the provisions of Rule 191A or Rule 191B of the Central Excise Rules, 1944 in respect of………………… (name of the item).

 

(Note: Strike out the declaration whichever is not applicable)

 

Name & Signature of the exporter……………..

 

(For use by the Customs Authorities)

 

Shipping Bill No. and Date………………………………………………

Name & Signature of the Customs Officer…………..

 

Annexure-III

 

DECLARATION TO BE FILED IN THE CASE OF EXPORT OF GOODS IN ANTICIPATION OF ISSUE OF AN ADVANCE LICENCE / DEEC

 

I / We __________________________________________________________ (name of the exporter) do hereby declare as follows: -

(a) that the shipment is in pursuance of discharge of the export obligation against export order No. ……………. Dated……………….; and
(b) I / We request for registration of the shipping bill in anticipation of the grant of an Licensing Authority, namely vide our application No. …………. Dated……. and for which I / We have obtained the letter of permit / receipt No…………….dated……….. from the said Licensing Authority;
(c)

that the following raw materials / components / consumables have been used for the manufacture of goods covered under this shipment, namely: -

  S. No. Description Quality Technical Characteristics Quantity Whether imported / indigenous
(d)

that I / we are availing the benefit of the provisions of Rule 191A or Rule 191B of the Central Excise Rules, 1944 in respect of………………… (name of the item).

 

(Note: Strike out the declaration whichever is not applicable)

 

Name & Signature of the exporter……………..

 

(For use by the Customs Authorities)

 

Shipping bill no. and date__________________________

 

Name & signature of the Customs officer________

 

 

Annexure-IV

DECLARATION TO BE MADE IN SHIPPING BILL FOR CONSIGNMENTS COVERED BY AR-4 PENDING WEIGHMENT AT THE DOCKS

In consideration of the Commissioner of Customs agreeing to assess the goods on the declared weight pending verification by reference to AR-4A Forms, I / We ________________________ (name of the exporter) do hereby agree: -

In consideration of the Commissioner of Customs agreeing to assess the goods on the declared weight pending verification by reference to AR-4A Forms, I / We _________________________________________ (name of the exporter) do hereby agree: -

(a)

to pay any extra duty / cess leviable on the goods covered by the shipping bills, and

(b)

to produce the AR-4A Forms covering the shipment to the Customs House with in 15 days of the shipment of the goods.

 

(Note: Strike out the declaration whichever is not applicable)

 

Name & Signature of the exporter_____________________

 

(For use by the Customs Authorities)

 

Shipping bill no. and Date_______________________________________

 

Name & Signature of the  Customs Officer__________________________

               

                                                     

Annexure-V

Declaration to be made by exporters who filed shipping bill without certificate from the export inspection agency ETC.

(a)

I/ We _____________________________ (name of the exporter) do hereby declare that the goods being despatched are / shall be in accordance with the conditions prescribed in the Export (Quality Control and Inspection) Act, 1963. Application for necessary inspection / quality control has been made to _______________________ (name of the export inspection agency) and the same in original will be produced along with the goods at the time of Customs examination;

(b)

I / We ___________________ (name of the exporter) do hereby declare that the goods are as per the quality control requirements under the export (quality control and inspection) act, 1963. Application for the issue such a certificate has been made to ____________ which is duly authorised agency to issue such a certificate. The said certificate will be produced to the Customs officer for checking at the time of shipment.

 

(Note: Strike out the declaration which is not applicable)

 

Name & Signature of the exporter___________________________

 

(For use by the Customs authorities)

Shipping Bill No. and Date_________________________________

 

Name & Signature of the Customs officer_____________________

 

Abbreviations

  SB No. Shipping Bill No.
  AR 4 Application for removal 4.
  QCCert No. Quality Control Certificate Number.
  RBI Code No. Reserve Bank of India Code Number.
  L/C No. Letter of Credit Number
 

CIF

Cost Insurance Freight.
  CFR Cost and Freight
  FOB Free on Board
  CHA Customs House Agent
  GR Form Guaranteed Receipt Form
  ETC Licence Export Trade Control Licence
  QC Certificate Quality Control Certificate
  DBK Drawback
  AWB No. Export General Manifesto No.
  BE Bill of Export
  CFR is the revised abbreviation adopted internationally for ‘Cost and Freight’ instead of “C & F” used earlier.

 

Shipping bill for export of goods under claim for duty drawback

Original

Exporter

Invoice No. & Date

Bill No. & Date

AR4/ AR4A No. & Date

Import-Export Code No.

Q/ Cert No. & Date

RBI Code No.

Consignee

Export Trade Control

If export under

Deferred Credit      [ ]

Joint Ventures       [ ]

Rupee Credit          [ ]

Others                     [ ]

RBI's Approval/Cir. No. &

Date

Custom House                              LIC No.

Agent

 

Pre-Carriage by

Place of Receipt by Pre-carrier

Type of Shipment

Outright Sale              [ ]

Consignment Export [ ]

 

Others specify            [ ]

Vessel/

Flight No.

Rotation No.

Originating From

 

 

Port of Loading

Nature of Contracts: CIF [   ] / CFR [  ]/FOB Others (specify)                       [   ]

Port of Discharge

Country of Destination

Exchange Rate U / S 14 of CA

Currency of Invoice

S. No.

Marks & Nos.

No. & Kind of Pkgs. Container Nos.

Statistical code & Description of Goods

 

Quantity

Value FOB

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency

Amount

Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods.

 

 

Currency.............

 

Amount..............

FOB value

 

 

Freight

 

 

Insurance          

Rate

 

Commission

 

 

Discount

 

 

Other

 

 

Deductions

 

 

SL. No.

Export Tariff No.

Assessable Value under Sec-14

Duty

Cess

Total Duty & Cess

Duty payment particulars

Rate

Amount

Rate

Amount

Total Duty & Cess Amount in words: Rupees

Collection

Stamp

Declaration:

I/We declare that all particulars given herein are true and correct

I/We also attach the declaration (s) under clause No. (s).................

Public Notice No......................... dated........................    Signature of Exporter

BILL OF EXPORT OF DUTIABLE GOODS

Export Promotion Copy

Original

 

Document Submitted

 

1. Invoice                         [  ]

2. Packing List                 [  ]

3. G R Form                       [  ]

4. AR-4 / AR-4A Form    [  ]

5. ETC Licence                 [  ]

6. Indent                           [  ]

7. Acceptance of Contract  [   ]

8. Letter of Credit

9. QC certificate

10. Port trust document

11. Any other (specify)

 

Shipping bill for export of goods under claim for duty drawback

Duplicate

Exporter

Invoice No. & Date

Bill No. & Date

AR4/ AR4A No. & Date

Import-Export Code No.

Q/ Cert No. & Date

RBI Code No.

Consignee

Export Trade Control

If export under

Deferred Credit      [ ]

Joint Ventures       [ ]

Rupee Credit          [ ]

Others                     [ ]

RBI's Approval/Cir. No. &

Date

Custom House                              LIC No.

Agent

 

Pre-Carriage by

Place of Receipt by Pre-carrier

Type of Shipment

Outright Sale              [ ]

Consignment Export [ ]

 

Others specify            [ ]

Vessel/

Flight No.

Rotation No.

Originating From

 

 

Port of Loading

Nature of Contracts: CIF [   ] / CFR [  ]/FOB Others (specify)                       [   ]

Port of Discharge

Country of Destination

Exchange Rate U / S 14 of CA

Currency of Invoice

S. No.

Marks & Nos.

No. & Kind of Pkgs. Container Nos.

Statistical code & Description of Goods

 

Quantity

Value FOB

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency

Amount

Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods.

 

 

Currency.............

 

Amount..............

FOB value

 

 

Freight

 

 

Insurance          

Rate

 

Commission

 

 

Discount

 

 

Other

 

 

Deductions

 

 

SL. No.

Export Tariff No.

Assessable Value under Sec-14

Duty

Cess

Total Duty & Cess

Duty payment particulars

Rate

Amount

Rate

Amount

Total Duty & Cess Amount in words: Rupees

Collection

Stamp

Declaration:

I/We declare that all particulars given herein are true and correct

I/We also attach the declaration (s) under clause No. (s).................

Public Notice No......................... dated........................    Signature of Exporter

Shipping bill for export of goods under claim for duty drawback

Export Promotion Copy

Duplicate

 

Document Submitted

 

1. Invoice                         [  ]

2. Packing List                 [  ]

3. G R Form                       [  ]

4. AR-4 / AR-4A Form    [  ]

5. ETC Licence                 [  ]

6. Indent                           [  ]

7. Acceptance of Contract  [   ]

8. Letter of Credit

9. QC certificate

10. Port trust document

11. Any other (specify)

 

 

Shipping bill for export of goods under claim for duty drawback

Duplicate

I/We claim drawback of Rs. ………….... Under Sec-74/75 of Customs Act 1962 and Customs and Central Excise Duty Drawback Rules, 1971. I/We certify that the goods are new/used for ………….... I/We certify that I/We have complied with the conditions subject to which Drawback rates are applicable.

 

1. Name and address of Bank…………………………

………………………………………………………

……………………………………………………….

2. Account No…………………………………………

3. DBK Ledger No……………………………………

Document Submitted

 

1. Invoice                         [  ]

2. Packing List                 [  ]

3. G R Form                       [  ]

4. AR-4 / AR-4A Form    [  ]

5. ETC Licence                 [  ]

6. Indent                           [  ]

7. Acceptance of Contract  [   ]

8. Letter of Credit

9. QC certificate

10. Port trust document

11. Any other (specify)

Item No. in S/B

S. No. & Sub S. No. of DBK

Qty/Wt. On which DBK

Value on which DBK

Rate of DBK

Amount of DBK

 

Schedule

Claimed

Claimed Excise Customs Excise Customs Total

Total amount in words Rupees………………………….........

………………………………………………………………………..

Signature of Exporter / CHA

Let export

 

Signature

Allowed for shipment 

 

Signature

Vessel’s name may be altered after check with original entry for

Fresh one may be granted to………………….

For the portion or not shipped

Received

Handed over to C. W. A. / Party            Asst. Commissioner      Cashier

Contents received on Board

Date of shipment

Date                       Mater of Vessel

Customs officer

Examination order and report

 

Shipping bill for export of goods under claim for duty drawback

Triplicate

Exporter

Invoice No. & Date

Bill No. & Date

AR4/ AR4A No. & Date

Import-Export Code No.

Q/ Cert No. & Date

RBI Code No.

Consignee

Export Trade Control

If export under

Deferred Credit      [ ]

Joint Ventures       [ ]

Rupee Credit          [ ]

Others                     [ ]

RBI's Approval/Cir. No. &

Date

Custom House                              LIC No.

Agent

 

Pre-Carriage by

Place of Receipt by Pre-carrier

Type of Shipment

Outright Sale              [ ]

Consignment Export [ ]

 

Others specify            [ ]

Vessel/

Flight No.

Rotation No.

Originating From

 

 

Port of Loading

Nature of Contracts: CIF [   ] / CFR [  ]/FOB Others (specify)                       [   ]

Port of Discharge

Country of Destination

Exchange Rate U / S 14 of CA

Currency of Invoice

S. No.

Marks & Nos.

No. & Kind of Pkgs. Container Nos.

Statistical code & Description of Goods

 

Quantity

Value FOB

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency

Amount

Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods.

 

 

Currency.............

 

Amount..............

FOB value

 

 

Freight

 

 

Insurance          

Rate

 

Commission

 

 

Discount

 

 

Other

 

 

Deductions

 

 

SL. No.

Export Tariff No.

Assessable Value under Sec-14

Duty

Cess

Total Duty & Cess

Duty payment particulars

Rate

Amount

Rate

Amount

Total Duty & Cess Amount in words: Rupees

Collection

Stamp

Declaration:

I/We declare that all particulars given herein are true and correct

I/We also attach the declaration (s) under clause No. (s).................

Public Notice No......................... dated........................    Signature of Exporter

 

 

Shipping bill for export of goods under claim for duty drawback

 

Export Promotion Copy

Triplicate

I/We claim drawback of Rs. ………….... Under Sec-74/75 of Customs Act 1962 and Customs and Central Excise Duty Drawback Rules, 1971. I/We certify that the goods are new/used for ………….... I/We certify that I/We have complied with the conditions subject to which Drawback rates are applicable.

 

1. Name and address of Bank…………………………

     ……………………………………………………………………………………………………………….

2. Account No…………………………………………

3. DBK Ledger No……………………………………

Item No. in S/B

S. No. & Sub S. No. of DBK

Qty/Wt. On which DBK

Value on which DBK

Rate of DBK

Amount of DBK

 

Schedule

Claimed

Claimed Excise Customs Excise Customs Total

Total amount in words Rupees………………………….........

………………………………………………………………………..

Signature of Exporter / CHA

For department officer

 

Verified that the amount of DBK as claimed above is admissible subject to description found correct on the basis of physical examination / test etc.

Signature of A.O. & Stamp

Calculation

Checked.

 

 

 

 

 

Comptist

Pre-receipt form

 

Received the sum of Rs……………… as drawback.

 

Revenue

Stamp

Signature of Exporter / CHA

Let export

 

Signature of Officer of Customs

Allowed for shipment

 

Signature of Officer of Customs

Claim Pre-audited for Sanction Claim passed for Rs……………………
Inspector (Audit) Supdt. A/C
Claim Registration No………….. issued Cheque No……….. Dated…………
For Rs……………….. (Rupees…………………………)

Dealing Clerk

Officer

   

 

Shipping bill for export of goods under claim for duty drawback

Quadruplicate

Exporter

Invoice No. & Date

Bill No. & Date

AR4/ AR4A No. & Date

Import-Export Code No.

Q/ Cert No. & Date

RBI Code No.

Consignee

Export Trade Control

If export under

Deferred Credit      [ ]

Joint Ventures       [ ]

Rupee Credit          [ ]

Others                     [ ]

RBI's Approval/Cir. No. &

Date

Custom House                              LIC No.

Agent

 

Pre-Carriage by

Place of Receipt by Pre-carrier

Type of Shipment

Outright Sale              [ ]

Consignment Export [ ]

 

Others specify            [ ]

Vessel/

Flight No.

Rotation No.

Originating From

 

 

Port of Loading

Nature of Contracts: CIF [   ] / CFR [  ]/FOB Others (specify)                       [   ]

Port of Discharge

Country of Destination

Exchange Rate U / S 14 of CA

Currency of Invoice

S. No.

Marks & Nos.

No. & Kind of Pkgs. Container Nos.

Statistical code & Description of Goods

 

Quantity

Value FOB

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency

Amount

Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods.

 

 

Currency.............

 

Amount..............

FOB value

 

 

Freight

 

 

Insurance          

Rate

 

Commission

 

 

Discount

 

 

Other

 

 

Deductions

 

 

SL. No.

Export Tariff No.

Assessable Value under Sec-14

Duty

Cess

Total Duty & Cess

Duty payment particulars

Rate

Amount

Rate

Amount

Total Duty & Cess Amount in words: Rupees

Collection

Stamp

Declaration:

I/We declare that all particulars given herein are true and correct

I/We also attach the declaration (s) under clause No. (s).................

Public Notice No......................... dated........................    Signature of Exporter

 

Shipping bill for export of goods under claim for duty drawback

 

Export Promotion Copy

Quadruplicate

Verified Mate’s Receipt No……………………………………………………… issued by………………………. ............... For……………………………………………Cases/Bales/Packages/Containers………………..

……………………………………………………………………………………………………………………...........

Shipped per……………………………………………………………………………......................................

Which sailed on……………………………………………………………………………………........................

From…………………………………………………………………………………………………….....................

 

Under Preventive Supervision

 

Signature of Officer of Customs

 

OR

 

Shipment declared on this Shipping Bill has been air freighted on

 

Flight No…………….......                                                                     Dated………...........

 

AWB No……………………                                                                     EGM No……………….

 

Under Preventive Supervision in full / part (Specify quantity air freighted).

 

Signature of Officer of Customs