Form I

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..... hellip;…………. Date of Issue ……………..………. Details of the SEZ dealer, to whom issued (a) Name and Address ………………………………….………………….…. …………&helli .....

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..... thority To …..………………..…………………. …………………………..…………… (Name and address of the Seller, with name of the State) Certified that the goods *[ordered for in our Purchased Order Number ….&hellip .....

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..... hellip;……………………………………..…………………. Status of the persons signing the Declaration, in relation to the SEZ dealer……...….. ……………………………………&h .....

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