ANF- 5B
Application Form for Redemption of EPCG Authorization /Issuance of Post Export EPCG Duty
Credit Scrip)

(Please see the guidelines before filing the application)

1. Applicant Details
  a. IEC Number   Branch Code  
  b. Name    
  c. Address    

 

2.

EPCG Authorization No. and Date Duty Saved Amount allowed Duty Saved Amount utilized

(including indigenously procured CG)

       

 

3.

Installation Certificate No. and Date  

 

4. Export Product Details  
  a. Export product/services allowed as per the EPCG Authorization  
  b. Alternate Product/Services (if permitted) name & ITC(HS) code  

 

5. Export Obligation Period  
  a. Date of expiry of initial EOP  
  b. Extended EOP date  
  c. Actual EO completion date  

 

6.

Average Export Obligation imposed* EO as per actual duty saved amount
  In Indian Rs. In Indian Rs. In US$
       

* In case of fulfilment of EO by alternate product, Average EO of alternate product should also be given.

7.

Details of Physical Exports/Deemed Exports made/Services rendered for fulfilment of specific EO
 

Sl. No.

Products Exported/ Supplied/Services Rendered with ITC(HS) Code

Details of Shipping Bill/Voucher/Invoice/CT3/ARE3/ Lorry Receipt/ Railway Receipt etc.

FOB (in FFE)/FOR value
    Same
Product/Services
--------------------
Alternative
Product/Services

No.

Date Direct Exports Third Party Exports Deemed Exports By Group Company Other (R&D Services/ Royalty) Total
                     
                     
                     

 

8.

I/We further declare that I/we have made exports as under for maintenance of Average Export Obligation:
 

Financial Year

Average to be maintained

Average maintained

       

Declaration/Undertaking

I/We hereby declare/certify that:

1. I/We have updated my/our profile in ANF -1.
2. 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 withheld therefrom. If anything is found incorrect or false it will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.
3. None of the Partners(s)/Director(s)/ Trustee/ Karta/ Proprietor of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI.
4. None of the Partners(s)/Director(s)/ Trustee/ Karta/ Proprietor of the firm/company, as the case may be, is/are a Proprietor/Partner/Director/Karta/Trustee in any other firm/Company which has come under the adverse notice of DGFT or is in the caution list of RBI, to the best of my knowledge.
5. Neither the Registered Office of the company /Head Office of the firm nor any of its Branch Office(s)/Unit(s)/Division(s) has been declared a defaulter or has otherwise been made ineligible for undertaking import/export under any of the provisions of the Policy.
6. I/we have not exported items on the SCOMET list for which permission has not been taken.
7. I am authorized to verify and sign this declaration as per Paragraph 9.06 of the Foreign Trade Policy.

Place   Signature of the Applicant  
Date   Name  
    Designation  
    Official Address  
    Telephone/Mobile  
    Residential Address  
    Email-id  

8. All physical exports made as shown in item No. 7 and 8 above are in freely convertible currency

(Signature with Seal of the Chartered Accountant / Cost Accountant / Company Secretary)

Guidelines for Applicants

1. Application must be accompanied by the certificate in Appendix 5C duly signed by Chartered Accountant / Cost Accountant / Company Secretary