APPENDIX-4H

REGISTER FOR ACCOUNTING THE CONSUMPTION AND STOCKS OF DUTY FREE IMPORTED OR DOMESTICALLY PROCURED RAW MATERIALS, COMPONENTS ETC. ALLOWED UNDER ADVANCE AUTHORISATION / DFIA*

INPUTS ALLOWED
IN THE
AUTHORISATION
(S)
AUTHORISATON  *** CAN BE CLLUBED TOGETHER PURPOSE OF ACCOUNTING OF INPUTS		 PRODUCT (S) EXPORTED
UNDER THE
AUTHORISATION (S)		 EXCESS
INPUTS,
IF ANY
ALLOWED
UNDER
THE
AUTHORISATION(S).
(4 - 8)		 IN CASE OF EXCESS AS IN
COLUMN 9		 REMARK
S
Sl
No		 Authorisation
No(s)
with date
(A No. of
authorisations can
be
clubbed
together for  accounting purpose)		 Inputs Quantity Product Quantity Input actually consumed  for the exported product Additional
exports
effected in
proportion to excess input		 Input
quantity
reduced
proportionately in the
authorisation		 Customs
dutypaid
alongwith
interest		  
   
1 2 3 4 5 6 7 8 9 10 11 12 13

*In case of Post export replenishment, details of inputs used (whether duty paid or not) in the exported product has to be furnished.

**Applicable only in case either partial import or “NIL” import has been effected.

*** In case of transferable DFIA, information in the above format has to be furnished individual DFIA wise.
We declare that the aforesaid particulars are correct.

Place:
Date:

Signature of the authorisation holder: …........................................
Name in block letters:__________________
Designation:________________
Full official address:______________
Full Residential address :_______________
 

Appendix4H Continued

CHARTERED ACCOUNTANT / COST ACCOUNTANT/CERTIFICATE

I/We hereby confirm that I / We have examined the prescribed registers and also the relevant records of M/s..........................……………………………………………having IEC number……………………... and PAN number…………………….for the licensing period(s) ………………………………and hereby certify that the information furnished above is true and correctin all respects; no part of it is false or misleading and no relevant information has been concealed or withheld;

I / We fully understand that any statement made in this certificate, if proved incorrect or false, will render me/us liable to face any penal action or other consequences as may be prescribed in law or otherwise warranted.

I/We further declare that neither I, nor any of my/ our partners is a partner, director, or an employee of the above-named entity, its Group companies or its associated concerns.

(Signature and Stamp/ Seal of the Signatory)
(Chartered Accountant/ Cost Accountant)

Place:
Date:

Name of the Signatory:
Address:
Membership No:

Note:

1. Each page of this document is to be signed by the Chartered Accountant/Cost Accountant with his registration number.
2. Mention N.A. wherever the information required in the table is not applicable.
3. For columns 10, 11 & 12 of the table, please furnish the copy of the documentary evidence.
4. The authorisation holder is required to furnish the details for the authorisations which have been redeemed in the last licensing year.