APPENDIX 21A - FORMAT FOR DEPOSIT OF APPLICATION FEE - Foreign Trade Procedure (RE - 2012) / 2009-14 (From 5-6-2012 to 31-3-2015)

APPENDIX 21 A FORMAT FOR DEPOSIT OF APPLICATION FEE Receipt of Cash paid into the Central Bank of India at .............................. Bank Receipt Number and Date TO BE FILLED IN BY THE REMITTER To be filled in by the department officer of the bank By whom tendered Name, designation and address of the person on whose behalf money is paid Full particulars of the remittance and of authority (if any) Amount Rs. P. Head of account Accounts officer by whom adjustable Order to be Bank* Name Signature 1453 foreign trade export promotion - minor head - 102 import licence application fee Pay and Accounts officer .......... (Name of station) Date, correct receipt and grant receipt (signature and full description of the officer ordering the money to be paid in) * (in words) Rupees * To be used only in the case of remittance to the Bank through Departmental Officer Cashier Accountant Date Bank officer NOTE:- 1. Particulars of money tendered should be given below. 2. In case where direct credits at Bank are permissible the Column Head of Account will be filled in by the Bank Officer or Pay and Accounts Officer as the case may be, on the receipt of Bank's daily statement PARTICULARS AMOUNT Coins Notes (with details) Cheque (with details) Total Rs. Rs. P.