Customs and Central Excise Duties Drawback Rules, 2017 

ANNEXURE-I

FORM FOR CLAIM OF DRAWBACK UNDER RULE 12

Original

Ref. Dbk. Invoice No. Dated:

PART-I

Duplicate Triplicate Quadruplicate

PARTICULARS OF GOODS TO BE EXPORTED BY PARCEL POST UNDER CLAIM FOR DRAWBACK

FORM NO.

To

The Assistant/Deputy Commissioner of Customs (Drawback) Foreign Post Office                                                      

We,                                     propose to export the undermentioned consignment.

Name and Address of the Consignee

1. Certified that goods were not taken into use after the manufacture.

2. Certified that no separate claim for rebate of duty has been made or will be made to the Central Excise Authorities under rule 18 or rule 19 of Central Excise Rules, 2002 and that the Customs and Central Excise duty has been paid on the raw materials used in the manufacture of the goods. We hereby declare that the declaration made herein is true and correct.

Strike out whatever is not applicable.  

Dated:        Signature

Place:        Name

Official seal of the Exporter

Part-II

I have examined the above parcels which contain detailed above. The parcels have been packed in my presence and sealed by me with lead/wax seal No. bearing the following particulars       .

Date:                                            Signature of the officer who examined and sealed the consignment Place:

Certified that the above noted parcels were examined, packed and sealed under my supervision.

Date:                                                                Signature of Supdt. Of Customs/Central Excise Place:

Part-III

Forwarded alongwith                                     parcels to the Superintendent, foreign Post Office, New Delhi. Postal receipt No.                                                    .   

Date and Seal of Post Office

Post Master Post Office

Part-IV

Inspected                        parcels and found the seal intact. Examined                  parcels where the seals were not found intact.

Pass for export

Please detain for further action

Date:                                                                                        Signature of Examiner/Inspector

Place:                                                                                       Post Appraising Department

Seal of Office

(Place)

Part-V

Certified that the parcels detailed herein have been exported out of India on                        by           Air/Sea Ex. S.S.                                                . Forwarded to the Commissioner/Principal Commissioner of Customs.

Date:                                                                                        Signature of Superintendent
Place:                                                                                       Foreign Post Office