Appendix -4O - CERTIFICATE BY NOMINATED AGENCY / GJEPC FOR CLAIMING REPLENISHMENT OF GOLD / SILVER AGAINST JEWELLERY SOLD AT EXHIBITIONS ABROAD - Foreign Trade Procedure 2015-2020 (From 5-12-2017 to 31-3-2023) Revised

APPENDIX- 4 O CERTIFICATE BY NOMINATED AGENCY / GJEPC FOR CLAIMING REPLENISHMENT OF GOLD / SILVER AGAINST JEWELLERY SOLD AT EXHIBITIONS ABROAD Note : 1. Please see Paragraph 4.46 of the FTP and Paragraph 4.80 of Handbook of Procedures. 2. Please read the general instructions given in the Handbook of Procedures before filing this application. FOR OFFICAL USE File No.---------------------------------------------- Dated:---------------------- This is to certify that the following are the details of goods actually sold against invoice No.(s)______________________dated_____________in the exhibition and the foreign exchange repatriated into India and surrendered to the RBI / authorized dealer. The export has been in accordance with the Foreign Trade Policy, 2014-19. 1. Name of the Indian Exporter : .. 2. Exhibition held on : (i) Date: . From: .. To (ii) Place/Country 2. Exhibition held on : (i) Date: . From: ... To (ii) Place/Country 3. Organised by whom : .. 4. Details of Bank Guarantee, if any: .. 5. Price of gold / silver as per export invoice. S.No. Pieces Description Gross wt. Gms. Net wt. gms Value of gold/ silver as per rate of booking for replenishment Description/Type of studding/ diamonds/ precious semi-precious/ synthetic stones / pears Pieces (1) (2) (3) (4) (5) (6) (7) (8) Wt. In cts. Value of studdings Actual Sale Price And date of sale Making charges Value i.e. At rate of gold / silver At 6 Selling price in foreign currency FOB value repatriated Value Addition achieved With respect to value At 13. (9) (10) (11) (12) (13) (14) (15) (16) Signature : .. Name : .. Designation : . Name of the Nominated Agency : Seal