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EXCHANGE CONTROL DECLARATION (GR) FORM NO.

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..... Rupee Credit [ ] Others [ ] RBI's Approval/Cir.No. Date Custom House Agent L/C.No. Pre-Carriage by Place of Receipt Type of shipment : by Pre-Carrier Outright Sale [ ] Consignment Export [ ] Vessel/Flight No. Rotatio No. Others [ ] (Specify) .....

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..... Amount Other Deductions 2 EXCHANGE CONTROL DECLARATION (GR) FORM NO. Is Export under L/C arrangements? Yes [ ] No [ ] FOR CUSTOMS If yes, name of advising bank in India Customs Assessable value Rs. (Rupees . ........................................................................................ Bank through which payment is to be received Export Value Verified .....

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..... EXCHANGE CONTROL DECLARATION (GR) FORM NO. Duplicate Exporter Invoice No. Date SB No. Date AR4/AR4A No. Date Q/Cert No. Date Importer-Exporter Code No. Consignee Export Trade Control If export under: .....

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..... Net Weight Gross Weight Total FOB Value in words Analysis of Export Value Currency Amount Full export value OR where not ascertainable, the value which exporter expects to receive on the FOB Value sale of goods. Freight .....

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..... of which this declaration is made and that the particulars given above are true and that a)*the value as contracted with the buyer is the same as the full export value declared overleaf/ b) *the full export value of the goods is not ascertainable at the time of export and that the value declared is that which I/We, having regard to the prevailing market-conditions, expect to receive on the sale of goods in the overseas market. I/We undertake that I/We will deliver to the bank named herein the foreign exchange representing the full export value of the goods on or before @ ................................... in the manner specified in the Regulation made under the Act. I/We further declare that I/We am/are resident in India and I/We have a place of business in India. I/We* am/are OR am/are not in Caution List of the Reserve Bank of India. ...................................... .....

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..... Held with * --------------------- (1) (2) (3) (4) (5) (6) (7) * (Write the name of the concerned Indian Authorised Dealer Branch. ) Any other manner of receipt (Specify).................................................................................................................... --------------------------------------- (Stamp Signature of authorised dealer) Date:........................................ Address:....................................................... ................................................ ................................................ .....

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