ANF- 1 B

APPLICATION FORM FOR STATUS HOLDER CERTIFICATE

Please Note: The process of application for Status Holder Certificate is completely electronic and paperless. Applicant(s) may please navigate to the DGFT Website(https://dgft.gov.in) → Apply for Status Holder Certificate . The given ANF-1B is provided here for reference purposes. No paper copies or scanned copies of this ANF form are to be submitted to any Office(s) of DGFT

    (Kindly refer to Para 1.25 of FTP and Para 1.08 of HBP)

Part A – Applicant Details

1. Applicant Detail
IEC Number  

Branch Code

 
Name  
Address  
Telephone No  
Active Email ID  

                                                              

2. Application Details
Submission Date DD/MM/YYYY
Name of RA to which the application is submitted  

 

3. Category of Status applied for: please tick) (√ )  
a) One Star Export House  
b) Two Star Export House  
c) Three Star Export House  
d) Four Star Export House  
e) Five Star Export House  

Part B – Export Performance Details

4. Details of Statement of Exports / Deemed Exports / Foreign Exchange Earned by Supply of Service from India during preceding three (two for Gems and Jewelry Sector) financial years and current year (i.e. year in which application is being filed).

Statement of Exports / Deemed Exports / Foreign Exchange Earned by Supply of Service from India

 

Type of Exports in USD (FOB / FOR value / Foreign Exchange Earned)

Current Year in USD (Specify Period)

Previous Year 1 in USD

Previous Year 2 in USD

Previous Year 3 in USD(not applicable for Gems and Jewelry Sector)    

 

1. Exports of goods without Weightage        
2. Exports of services without Weightage        
3. Exports with Double Weightage        
4. FOR value converted in USD for Deemed Exports under FTP        
5. Exports Value converted in USD for receipts in INR under para 2.53 of FTP        
6. Exports of SEZs / EOUs / EHTPs /STPs/ BTPs units, if clubbing is sought        
7. Total (in USD)        
Note 1: A shipment / service transaction can be included only once in one of the categories eligible for double weightage.

Note 2: If the exports are in any other currency other than USD like Euro, INR etc, these shall be converted to USD on the date of realization as per rate notified by customs for export purposes.

Part C - Information Dissemination of Status Holders

5. Details of Categories of Products/Service Exports in line with IEC Profile.

6. Details of exports of Top 5 Merchandise HS lines and Top 5 service exports (if any) in the last financial year

Sl no

HS Code as per ITC HS (AT 6 DIGIT LEVEL)
1  
2  
3  
4  
5  
   
  % age of Top 5 items in total merchandise exports of last financial year - ….%
Sl no. Service Code as per CPC Codes (At 5 Digit Level)
1  
2  
3  
4  
5  
   
  % age of Top 5 service categories in total service exports of last financial year - …%

7. For information dissemination on DGFT Portal of List of Status Holders, the following details are to be provided by all Star Export Houses :

7.1 Brief Description of the Business ( in 100 word) :                                                        Upload: Product Brochure in PDF

7.2 Link of the Website:

7.3 : Email ID for Business Enquires:

8. Number of employees as on 31st March of Last Financial year :     

Part D - Skilling and Mentorship Obligation

9. Details to be provided by the Status Houses ( 2 star houses and above) as part of skilling and Mentorship Obligation mandated in Para 1.30 of FTP 2023

9.1 Details of the Intended Training to be taken up :

Financial Year (For current and next 5 years)

Duration of the training Program (In Weeks) District of the Training Program Likely number of Trainees intended t be taken Likely Venue of the Training Start Date (Month in MM/YY) End Date (Month MM/YY) Email id of the Contact Person Remarks
                 
                 

9.2 Whether the status house will be including factory visits/warehouse visits during the skilling and mentorship program: Yes/ No

9.3 Whether the status house will be collaborating with any Industrial Cluster: Yes/ No

9.4 Whether the status house will be collaborating with any Knowledge partner: Yes/ No

 9.5 Whether the status house will be providing interaction with Export Import Manager/Supply Chain Manager/ Logistics Manager for the Trainees: Yes/ No

 9.6 Whether the status holder will be providing Skilling and Mentorship Certificate at the end of the Training : Yes/No

Note: There might be requirement of uploading the Annual Status Report on the portal on later date: (i) Self-Declared Training Completion Certificate (ii) Self-Declared Outcome Report

Part E: Declaration

10. This is to certify that I have uploaded the scanned copy of the following documents :

a. Copy of earlier Status Certificate, if any

b. CA Certificate with UDIN number

11. DECLARATION/UNDERTAKING:

1.

I/We hereby certify that :

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

(i) The Customs Act,1962,

(ii) The Central Excise Act1944,

(iii) Foreign Trade (Development & Regulation) Act1992,

(iv) The Foreign Exchange Management Act,1999;and

(v) The Conservation of Foreign Exchange, Prevention of Smuggling Activities Act, 1974

(vi) GST Acts

B. None of the Directors/Partners/ Proprietor/Karta/Trustees of the company/firm /HUF/Trust,(as the case may be),is/are a Director(s)/Partner(s)/ Proprietor/Karta/ Trustee in any other Company/ firm / entity which is on the Denied Entity List (DEL) of DGFT

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

2.

I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, as amended from time to time, the Rules and Orders framed there under the Foreign Trade Policy and the Handbook of Procedures

3.

I/We hereby certify that that particulars and statements made in this application are true and correct and nothing has been concealed or held there from. 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
4. I hereby certify that I am authorized to verify and sign this declaration as per Foreign Trade Policy
5. I hereby declare that a shipment / service export transaction has been included only once in one of the categories eligible for double weightage. I also understand that service transactions which are as per para 11.51 of the FTP has been counted, for claim in this application, if any.

6.

I hereby declare that exports made on re-export basis have not been included and also any exports with disclaimer has not been counted as per status holder provisions detailed in chapter 1 of FTP.

7.

I hereby declare that only such exports has been taken into account for seeking recognition, which has been realized by me in our bank account directly from overseas.

8.

I am aware of Skilling and Mentorship provisions in Para 1.30 of FTP 2023. I will provide the support on best-endeavor basis to the initiative.

Tick the box as acceptance of declaration/ undertaking

Signature of the Applicant Digitally Signed with DSC

Annexure to ANF 1 B

CERTIFICATE OF CHARTERED ACCOUNTANT (CA)

COST AND WORKS ACCOUNTANT (ICWA)/ COMPANY SECRETARY (CS)

I / We hereby confirm that I / We have examined prescribed registers and also relevant records of M/s ....... .............……………………………………………having IEC Number ......................................... for Financial year (s)......................................................and hereby certify that:

1 Following documents / records have been furnished by applicant firm / company and have been examined and verified by me / us namely:-

a) Statutory documentations under Customs Act 1962 and GST Acts, Foreign Trade (Development & Regulation) Act 1992 as amended;

b) Export Order / Contract, Shipping Bills, Bill of Lading (and / or Airways Bills / PP Receipts), Customs / Bank attested Invoices, Forward Inward Remittance Certificates (FIRCs), GR declaration and connected books of accounts;

c) FIRCs, e-BRC, Certificate, Bank Advice from international credit card companies.

2 Information given by the applicant firm / company in ANF 1B is in agreement with FTP2023 as amended from time to time, and rules and procedures made there under. Relevant register and records and books of accounts maintained by M/s............... is also true and correct.

3 It has been ensured that

a) Information furnished is true and correct in all respects; no part of it is false or misleading and no relevant information has been concealed or withheld;

b) In respect of export of goods, a shipment is counted in applicants export turnover / performance only if the realization of export proceeds from overseas is in the applicant’s bank account.

c) In respect of service providers, realization of export proceeds in free foreign exchange pertains to rendering of services.

d) If the exports are in any other currency other than USD like Euro etc, these are converted to USD as per rate notified by customs for export purposes.

e) If the eligible exports are Deemed Exports or have had realizations in Indian Rupees, the same has been converted to USD as per rate notified by customs for export purposes.

4 Neither I, nor any of my / our partners is a partner, director, or an employee of above-named entity, its Group companies or its associated concerns;

5 I / We further certify that export proceeds for shipments during last three years (two years for Gems and Jewelry Sector) plus current year are not outstanding beyond prescribed period as permitted by RBI.

6 The statement of Exports / Deemed Exports / Foreign Exchange Earned by Supply of Service has been calculated as under:

                      Statement of Exports / Deemed Exports / Foreign Exchange Earned by Supply of Service from India

Type of Exports in USD (FOB / FOR value / Foreign Exchange Earned) Current Year in USD Previous Year 1 in USD Previous Year 2in USD Previous Year 3in USD (not applicable for Gems and Jewelry Sector)
1. Exports of goods without weightage        
2. Exports of services without weightage (As per Format A)        
3. Exports with Double weightage (As per Format B)        
4. FOR value converted in USD for Deemed Exports (As per Format C)        
5. Value converted in USD for receipts under para 2.53 of FTP(As per Format D)        
6. Exports of SEZs / EOUs / EHTPs / STPs / BTPs, if clubbing is sought(As per format E)        
7. Total (in USD)        
Note 1: A shipment can be included only once in one of the categories eligible for double weightage.

Note 2: If the exports are in any other currency other than USD like Euro, INR etc, these shall be converted to USD on the date of realization as per rate notified by customs for export purposes.

12. 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.

13.

Place:________________ Signature of CA/ ICWA /CS:
Date:_________________ Name of the Signatory:____________________
  Address: ____________________
  Membership No:___________________
  Phone Number:___________________
  Email :_______________________

 

Format A

Certificate of Foreign Exchange Earned by Supply of Service

Sl. No Category of Service Provider Particulars Foreign Exchange Earned USD in current year Foreign Exchange Earned USD in previous year 1 Foreign Exchange Earned USD in previous year 2 Foreign Exchange Earned USD in previous year 3 (not applicable for Gems and Jewelry Sector)

1

Mode 1 as per Chapter 11

 

 

 

 

 

2 Mode 2 as per Chapter 11          
3 Mode 3 as per Chapter 11          
4 Mode 4 as per Chapter 11          
5 Total Foreign Exchange Earned by Supply of Service (USD)        

 

Format B

Certificate of Exports where Double Weightage has been claimed (Applicable only if the application is for One Star Export House)

Note: A shipment can be included in one of categories indicated below only once.

SL.No.

Category of Exports

FOB/FOR/Foregin Exchange earned in USD in Current Year 

FOB/FOR Foreign Exchange earned in USD in Previous Year 1

FOB/FOR Foreign Exchange earned in USD in Previous Year 2

FOB/FOR Foreign Exchange earned in USD in Previous Year 3(not applicable for Gems and Jewelry Sector)

1 Micro and Small Enterprises as defined in Micro, Small & Medium Enterprises Development (MSMED) Act 2006        
2 Manufacturing units having ISO/BIS Certification        
3 Units located in North Eastern States including Sikkim, and Union Territories of Jammu , Kashmir and Ladakh        
4 Export of fruits and vegetables falling under Chapters 7 and 8 of ITC HS        
5 Total FOB Value in USD        
6 FOB Value of Exports with Double Weightage (USD) = [2 X Total FOB Value of Row 5 above]        

 

Format C

Certificate of FOR value of Deemed Exports

Sl. No.

Category of Deemed Exports (Please quote the relevant sub para in brackets)

FOR (Rs in Cr) in current year

FOR (Rs in Cr) in previous year 1 FOR (Rs in Cr) in previous year 2 FOR (Rs in Cr) in previous year 3 (not applicable for Gems and Jewelry Sector)
1 7.02(a)        
2 7.02(b)        
3 7.02(c)        
4 7.02(d)        
5 7.02(e)        
6 7.02(f)        
7 7.02(g)        
7 Total FOR Value (Rs in Cr)        
8 Total Equivalent USD        

 

Format D

Receipts under Para 2.53 of FTP

Sl. No. Receipts under Para 2.53 of FTP Equivalent Foreign Exchange Earned USD in current year Equivalent Foreign Exchange Earned USD in previous year 1 Equivalent Foreign Exchange Earned USD in previous year 2 Equivalent Foreign Exchange Earned USD in previous year 3 (not applicable for Gems and Jewelry Sector)
1

Exports to Iran

       
2

Exports through Special Vostro Account Mechanism

       
3

Total Equivalent USD

       

 

Format E

Exports from SEZs / EOUs / EHTPs / STPs / BTPs units which are included in IEC and is taken for calculation of grant of status

Sl. No.

Names of Exporting Units

FOB value in USD in current year

FOB value in USD in previous year 1

FOB value in USD in previous year 2

FOB value in USD in previous year 3 (not applicable for Gems and Jewelry Sector)

1 2 3 4 5  
1

SEZs

       
2

EOUs

       
3

EHTPs

       
4

STPs

       
5

BTPs

       
6 Total FOB Value (in USD)        

 

Place:-___________ Signature of CA/ ICWA /CS:__________________
Date:____________ Name of the Signatory: _________________
  Address:_______________
  Membership No________________
  Phone Number
  Email:_________________

Note: Each page of certificate of Chartered Accountant (CA)/ Cost and Works Accountant (ICWA)/Company Secretary (CS) including Format A to E need to be signed and stamped (or Digital Signed as the case may be)