ANF- 5A

(Application Form for Issuance of EPCG Authorisation)

(Please see the guidelines before filling the application)

1. Applicant Details
IEC Number   Entity Name  
Application Number   File Number  
Applicable Exchange Import Rate   Applicable Exchange Export Rate  
Branch Code   Address of the Applicant  
Are you a Common Service Provider? O Yes O No Are proposed capital goods sought to be imported are to be used by the supporting manufacturer? O Yes O No
Port of Registration (for the purpose of imports)   Sector Classification of Capital Goods sought to be imported under the Scheme. Are You Manufacturer or Service provider?

O Manufacturer

O Service Provider

 
Are you MSME? (if Yes, Pl attach proof) O Yes O No    
If manufacturer, please select sector classification of export items for which EPCG authorisation is applied for:

1. Engineering Products

2. Electronic Products

3. Drugs and Pharmaceuticals

4. Chemical and Allied Products

5. Apparel and Ready Made Garments

6. Madeups and Home decor items

7. Fabrics

8. Textile accessories

9. Yarns

10. Fish, marine and Meat Products

11. Agriculture and Processed Foods of Agriculture

12. Handicrafts Products

13. Leather Products

14. Plastic Products

15. Sports Goods

16. Gem and Jewellery Products

17. Other

If Service Provider, please select sector classification of service rendered for which EPCG authorisation is applied for:

1. Hospitality Sector (including Tourism)

 2. Healthcare sector

3. Port handling Service

4. R&D services

5. Engineering Services

6. IT & ITES

7. Other

 

2. RCMC Details
S.No. RCMC Number Date Issuing authority, (if applicable) Validity Upto Products for which registered
           

 

3. GSTN/Excise Registration Details

S.No.

Branch code Address of the factory / premises where the items to be imported are proposed to be used GST Number Jurisdictional Central Excise/GST Authority under whose jurisdiction the factory/ premisessituated
         
         

 

4. Details of exports of same/similar product/services made in the preceding three licensing years (excluding exports which have been counted / are being counted for fulfilling specific EO in respect of EPCG Authorisations within valid EO Period)

S.No. Financial Year Total FOB Value of exports/services rendered for the same/similar product/services (INR)
     
     
  Total (INR)  
  * Average export performance (INR)  

* If an applicant has been in existence for less than 3 years, the aggregate export will be divided by the number of years for which the company has been in existence and not by 3 years.

5. Supporting Manufacturer Details
S. No S.No. of Supporting Manufacturer GST N Registration Number Name of Supporting Manufacturer Supporting Manufacturer Address Line Supporting Manufacturer City Supporting Manufacturer State Supporting Manufacturer PinCode Type of Unit MSME/ IEM/LOI/ IL Registration No MSME/ IEM/LOI/ IL Registration Date Products endorse d on MSME/ L OI/IL/IEM Registration Issuing authority , (if applicable) Factory Addresses
                           

 

6. Products to be exported/services to be rendered
S.No. S.No. of Item Export Type ITC(HS) Code/ Service Code Products to be exported/services to be rendered Technical specification for product Whether product to be exported is restricted for export
             

 

7. Details of Capital Goods sought to be imported
Currency of Imports   Freely convertible currency   Postal address of the jurisdictional Central Excise/GST Authority in whose jurisdiction factory/premises of the applicant/supporting manufacturer where the capital goods to be imported are proposed to be installed  
S.No. S.No. of Item ITC ( HS) Cod e Description of the items of import Technical Specifications of the product to be imported Nature of Capital Goods sought to be imported Quantity Unit of Measure Primary use of Capital Goods sought to be imported Whether product to be imported is restricted for import

Details of Duty

Total effective Customs duty on items to be imported (in %) CIF value of imports/deemed imports (INR Duty saved amount (INR) Country of Origin
         

• Capital Goods

• Spares

• Tools

• Jigs

• Fixtures

• Dies

• Moulds

• Spare refractories

• Catalyst 

 •Computer software systems

• Others

    Preproduction activity/ Production activity/ Postproduction activity/ for rendering services          
                           

 

Amount to be paid (INR)   Total Saved Duty Value (INR)  
Total CIF value of Imports applied for (INR)   Total CIF value of Importsapplied for (In US $)  
Total CIF value of Imports applied for (In currency of imports)   Total CIF value of Imports applied for (In FCC)  

 

7. Details of Restricted Capital Goods applied for import
  S. No Description of the items of import ITC(HS) Code Nature of Capital Goods sought to be imported* Primary use of Capital Goods sought to be imported**
           

* Whether Capital Goods/Spares/Tools/Jigs/Fixtures/Dies/Moulds/Spare refractories/Catalyst/computer software systems (specify if any other)

** Whether used for Pre-production activity/Production activity/Post-production activity/for rendering services

8. Indigenous Details
IEC of Supplier Name of the Supplier Firm Address of the Supplier Jurisdictional DGFT RA of the Supplier Supplier Letter Type
         

 

Total CIF value of Imports invalidated (In INR)   Total CIF value of Imports invalidated (In US$)  
Total CIF value of Imports invalidated (In currency of imports)   Total CIF value of Imports invalidated (In FCC)  
Total Notional Duty Saved Value (INR)   Total exemption (GST duty in notional value)  
Total exemption (Basic custom duty in notional value)    

 

9. Bank Guarantee Details
Type of Guarantee Unique Document ID Start Date End Date IFS Code Bank Details INR Value Status
               

 

10. Details of Export Obligation imposed
Total duty saved/ duty paid (INR) Specific Export Obligation to be imposed (First Block) Specific Export Obligation to be imposed (Second Block) Specific Export Obligation to be imposed (over all) Specific Export Obligation to be imposed without exemption (if disallowed) Average Export Obligation to be imposed (INR)
  INR USD INR USD INR USD INR USD
                   

 

11. Details of EPCG Authorisations where EO is pending
S. No. Authorisation No. and Date RA which Issued the Authorisation Value of Duty saved/ duty paid (in INR) EO fixed on Duty saved/duty paid (in freely convertible currency)/INR Specific EO fulfilled Annual Average EO fixed (in INR) Expiry date of EO period
               

Are you eligible for:

Reduced EO for Green Technology Products

Reduced EO for North East Region, Jammu & Kashmir and Ladakh

Reduced EO for indigenously procured Capital Goods

Exemption from maintenance of average export obligation

Early fulfillment of EO

I have validated the submitted application for any errors.

Attachment Details
Attachment Type Remark Attachment Name
     
CA/CE Details
Sl. No. Application Number CA/CE Membership Number Appendix Type
       
       

 

12. Declaration/Undertaking

I /we, hereby, declare/certify that :

1. 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 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.

2. I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, (as amended) the Rules and Orders framed there under, the Foreign Trade Policy, the Handbook of Procedures and the ITC(HS) Classification of Export &Import Items as amended from time to time.

3. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI.

4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company, as the case may be, is/are a Proprietor/Partner(s)/Director(s)/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/Head Office of the firm/company 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.

6. I/We shall not export items on the SCOMET list for which authorisation has not been taken.

7. I/We do not come under the purview of Service Tax and therefore are not registered with the Service Tax Authorities. (in case of Service Providers who are not covered under service tax).

8. In respect of goods for which nexus is not established at a later date, I/We shall, without demur, pay to the Government Customs duty saved [together with applicable interest] on such imported goods which are found having no relation with product exported or service rendered.

9. I/We undertake to submit a self-certified copy of Drug Manufacturing Licences in case of export of Pharmaceutical Product(s) within a period of three years from the date of issue of EPCG Authorisation failing which the Bank Guarantee/Legal undertaking executed/furnished at the time of clearance of Capital Goods with Customs authorities/Regional Authorities of DGFT, as the case may be, is liable to be forfeited/invoked and I/We would be liable to pay Customs Duty saved amount together with applicable interest thereon from the date of first import till the date of final payment.

10. I am authorised to verify and sign this declaration as per paragraph 11.06 of the Foreign Trade Policy.

 

You have ticked the box as acceptance of declaration/ undertaking details.
Place   Date  
Name   Designation  
Email   Mobile  
Office Address  
Residential Address  

GUIDELINES FOR APPLICANTS

1. Application shall be filed online using digital signatures.

2. Applicant shall upload the documents as per details given below:

a. Self-certified copy of MSME/IEM/LOI/IL in case of products and GST Registration in case of Service Providers.

b. In such cases RCMC from EPC concerned will suffice).

c. Certificate from a Chartered Engineer in the format given in Appendix 5A.

d. Certificate of Chartered Accountant / Cost Accountant /Company Secretary in Appendix 5B.

e. In case of Import of spares, tools, refractories and catalyst for existing plant and machinery, a list of plant/machinery already installed in the factory/premises of the applicant firm/supporting manufacturer for which the above items are required, duly certified by a Chartered Engineer or jurisdictional Central Excise authority.

f. In case of EPCG applications made by de-bonding EOU/SEZ units, a self-certified copy of the ‘No Objection Certificate’ from the Development Commissioner concerned showing the details of the capital goods imported/indigenously procured by the applicant firm, its value at the time of import/sourcing and the depreciated value for the purpose of assessment of duty under the Scheme is to be submitted.

3. In case CG sought to be imported/item to be exported is under restricted category, a copy of this application shall be sent to EFC at DGFT Hqrs. also. (In such cases no separate application fee shall be required to be submitted while sending the copy of the application to Hqrs. EFC).Upon clearance by EFC, EPCG Authorisation shall be issued by RA and will bear an endorsement that EFC has approved issue of EPCG Authorisation for restricted CG/export item.

4. CSP approval letter under Para 5.02(b) of FTP 2023

The designating/certifying authority should call for the following documents:-

a. IEC

b. RCMC

c. Common service to be provided (in brief)

d. List of minimum six potential users (Name and IEC)

e. Name of the TEE where the applicant unit is located

f. Product category to be serviced

g. The unit should be duly registered with relevant GST authorities prior to export.