ANF-10A

ANF-10A
APPLICATION FORM FOR EXPORT OF SCOMET ITEMS LISTED IN APPENDIX 3 TO SCHEDULE 2 OF
ITC (HS) CLASSIFICATION OF EXPORT AND IMPORT ITEMS

1. Applicant Details:

i. IEC

ii. Name

iii. Address

Flat/Plot/Block No.

Street/Area/Locality

City

State

PIN Code

v. Tele No.

(1)

Country Code

Area Code

Tel. No.

(2)

v. Fax No.

Country Code

Area Code

Fax No.

vi. E-mail address where authorization to be sent

E-mail(1)

E-mail(2)

2. Details of SCOMET items in Appendix 3 to Schedule 2 of ITC (HS) Classifications of Export & Import Items applied for export: (If required, attach extra sheet (A4 size) in the same format)
Sl. No.	SCOMET Category i.e. 1B, 1C, 2, 3, 4,5 and 7	SCOMET Item No	Description of export item/s including technical specification	ITC (HS) Code No.(if available)	Quantity	Total FOB Value
						In relevant Foreign Currency	In Rupees	In US$

3.Details of exports of SCOMET items in the preceding 3 licensing years .(Details of the export last made ,if no export was made during the preceding licensing year): ( If required, attach extra sheet (A4 size) in the same format)
Sl. No	Export License No. & Date and Issuing Regional Authority	Details of items exported		Quantity exported	Country To which exported	DGFT’s(HQ’s)File Number
Sl. No	Export License No. & Date and Issuing Regional Authority	Category	Description	Quantity exported	Country To which exported	DGFT’s(HQ’s)File Number

6A. Foreign Buyer Details:

i. Name

ii. Address

Flat/Plot/Block No

Street/Area/Loca lity

City

Country

Postal Code

iii. Telephone No.

(1)

Country Code

Area Code

Tel .No

(2)

iv. Fax No.

Country Code

Area Code

Fax No.

v. E-mail

vi. Export Order No. and date

6B. Consignee Details: (If same as Foreign Buyer write “SAME” as in 6A”)

i. Name

ii. Address

Flat/Plot/Block No.

Street/Area/ Locality

City

Country

Postal Code

iii. Telephone No.

(1)

Country Code

Area Code

Tel. No.

(2)

v. Fax No.

Country Code

Area Code

Fax No.

vi. E-mail

6C. End User Details:(If same as Foreign Buyer and /or Consignee write “Same as” in 6A and/or 6B”as the case maybe)

i. Name

ii. Address

Flat/Plot/Block No.

Street/Area/Locality

City

Country

Postal Code

iii. Telephone No.

Country Code

Area Code

Tel .No.

iv. Fax No.

Country Code

Area Code

Fax No.

v. E-mail

vii. End product for which the item of export will be used by the end user

7. Details of Banks through which financial transactions relating to this export will be executed:

a. In Destination Country

i. Name of the Bank

ii. Address of the Bank

Flat/Plot/Block No.

Street/Area/Locality

City

Country

Postal Code

ii. SWIFT Code:

iii. IBANK

B. In India

i. Name of the Bank

ii. Address of the Bank

PIN Code

ii. IFSC Code

8. If applied for export on repeat basis in the same licensing year for same product , same end use and to The same end user, please furnish:

i. Reference Number and date vide which earlier permission was granted

ii. Export License number and date

iii. Quantity allowed for export

iv. Quantity exported on the date of this application

9. Details of Producer / Manufacturer of the item to be exported:
i. Name
ii. Address	Flat/Plot/Block No.
	Street/Area/Locality
	City
	State	PIN Code

For Use in DEFT office only (To be filled by the applicant). 11 A. Application Submission Details(if submitted electronically):
i. ECOM Reference Number
ii. Date of Submission on Server
iii. Submitted to which Regional Authority
iv. File Number & Date of Issue
iv. Application Fee submission details viz. Amount in Rupees, Demand Draft No./Electronic Fund Transfer No. and Date and the name & branch of the bank on which drawn
11B. Jurisdictional Regional Authority:

(i) I/We hereby declare that 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 held there from.

(ii) I/We fully understand that any information furnished in the application if found incorrect or false will render me / us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.

(iii) 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, Appendices and Aayat Niryat Forms and ITC (HS).

A. The entity for whom the application has been made have not been penalized under any of the following Acts (as a mended from time to time):

B. None of the Directors/Partners/Proprietor/Karta/Trusteesofthecompany/firm/HUF/Trust, (as the case may be), is/areaDirector(s)/Partner(s)/Proprietor/Karta/TrusteeinanyotherCompany/firm/entitywhichis on the Denied Entity List (DEL) of DGFT or is in the caution list of RBI;

C. 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 and has otherwise been made ineligible for undertaking import/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/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 / 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/ authorisations issued to us for export of SCOMET items and wherever required have duly intimated the o/o DGFT, New Delhi along with documentaryevidenceregardingreceiptoftheitemsofexportbytheend-userwithinthestipulatedtime.

(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 ITC (HS)and submit all requisite documents to the o/o DGFT (SCOMET Section), failing which I/We shall be liable to action under FT (D & R) Act, 1992 as amended or rules and orders made there under, and the CustomsAct,1962.

(viii) I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.6 of the Policy

Signature of the Applicant

Name

Designation

Official Address

Flat/Plot/Block No.

Street/Area/Locality

City

State

PIN Code

Telephone

Country Code

Area Code

Tel.No.

Place:

Date:

2. One original application in the prescribed format ANF 10A and ANF 1 and six copies thereof along with self-certified copies of the documents as in Para 3 below must be submitted to DGFT (HQ), Vanjiya Bhawan, New Delhi Each page of the original application has to be signed by the applicant with stamp of the company.

3.   Application must be accompanied by self-certified copies of the following documents:
      (i) Purchase Order from the Foreign Buyer, Consignee and End–User in respect of items mentioned in Col.2 of ANF10A
     (ii) End User Certificate(s) (Also see Para 4 below).
     (iii) Technical Specifications (not Exceeding One Page for Each item) for the items to be exported.
     (iv) (a) Bills of Entry (BEs) into the destination country for items exported during the last one year as per information in column No. 3 of the application. In Col. 3 details of exports are to be given for last 3years. However, Bes for the last 1 year only is to be submitted.

(b) BEs as above are to be submitted with the 1st application of the financial year only. From the 2 nd application onwards, the exporter shall make are reference in the forwarding letter that the BEs have been submitted with the 1st application giving DGFT’s File No. of 1st application. Copy of the forwarding letter of 1st application to be attached with every subsequent application.
(v) If a third party or contractor is involved, details of Contract or Agreement between the Foreign Buyer and End User with third party must be submitted, along with copy of contract or agreement.

4. End User Certificate :-Original End User certificate in the prescribed format Appendix 10J(i), 10J(ii), applicable

Letter Head of all entities in the chain of supply viz. the foreign buyer, the end user and intermediaries /consignee (if they are different from the foreign buyer and end user) indicating complete details of the export product, end product, end purpose for which the item of export will be used by end user and complete address and telephone No. of end user must be furnished along with original application. End User Certificate from the following must also be submitted:

5. Details of the item(s) given in ANF10A, End User Certificate(s) and Purchase Order(s)must match completely.

6. While filling ANF 10A, care should be taken to ensure the following:-
     (i) Category of the items proposed to be exported as per Appendix3 of ITC (HS)         Classifications of Export and Import Items should be clearly mentioned.
    (ii) Port of discharge and route must be clearly defined. Route/mode of transport cannot be changed after export license has been issued.
    (iii) Against column 6A, 6B &6C, complete address should be given. P.O. Box No. will not be accepted.
    (iv) All columns must be filled correctly and completely.

4. Shipment Details:
i. Port of Loading/Shipment
ii. Port of Discharge
iii. Country to which item to be exported
iv. Ultimate Destination Country

5. Purpose of Export (please tick and give clarification if any):
Trade
Sample
Display/Exhibition

viii. Purpose for which the end product will be utilized
ix. Is end user an entity of Government of destination country?
x. Manufacturing / Business /other activity of the end user