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APPLICATION FORM FOR SETTING UP OF NEW EOU/EHTP/STP/BTP UNIT OR CONVERSION OF EXISTING DTA/EHTP/STP/BTP UNIT

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..... ____________________ Date__________Month____________Year __________ Details of Bank Draft Amount Rs. ___________________ Draft No. ___________________ Draft date ___________________ Drawn on ___________________ (Name of the Bank) Payable at ____________________ ---------------------------------------------------------------------------------------------------------------------------------------------------- Indicate (√) Whether the Application Is For: AUTOMATIC APPROVAL Or BOARD OF APPROVAL Application for: (i) Setting up of new Unit (ii) Conversion of existing DTA unit into EOU (iii) Conversion of Existing STP/EHTP to EOU (In case of conversion, please attach fact sheet as per Annexure) I. NAME AND ADDRESS OF THE UNDERTAKING IN FULL (Block Letters) Name of the Applicant Firm _________________________________ Full Address _________________________________ (Regd. Office in case of limited companies & Head Office for others) Pin Code _________________________________ Tel. No. _________________________________ Fax No. _________________________________ Permanent E-Mail Address _________________________________ Web-Site, if any ________________________ .....

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..... it =) Item Code (ITC HS code No) (Not required for service unit) --------------------------- -------------------------- -------------------------------------- --------------------------- -------------------------- -------------------------------------- --------------------------- -------------------------- -------------------------------------- V-A Intermediate Products, if any, which are to be taken out for job work abroad as part of production process. Item(s) Description Quantity Item Code(ITC HS Code No.) (Not required for service unit) ________________ ________________ _______________________ ________________ ________________ _______________________ ________________ ________________ _______________________ VI. PRODUCTION (In case of more than one item, supplementary sheets may be used) Quantity (Unit __________) (Value (In Rupees) (Not required for service unit) 1st year ___________________ __________________ 2nd year ___________________ __________________ 3rd year ___________________ __________________ 4th year ___________________ __________________ 5th year ___________________ __________________ VII. Indigenous Requirement: (Value .....

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..... ort of machinery (ii) Import of raw materials and components (iii) Import of spares and consumables (iv) Repatriation of dividends and profits to foreign collaborators (v) Royalty (vi) Lump sum know-how fee (vii) Design and drawing fee (viiii) Payment of foreign technicians (ix) Payment on training of Indian technicians abroad (x) Commission on Export etc. (xi) Foreign Travel (xii) Amount of interest to be paid on external commercial borrowing/ deferred payment credit (specify details) (xiii) Any other payments(specify details) Total (i)to(xiii) Net Foreign Exchange earnings in five years XIV. REJECTS (Only for EOU manufacturing units.) Generation of Rejects/Sub-standard __________ __________________ finished goods __________ __________________ (percentage of 5 yrs production) (Qty.(Unit = ) Goods (In case rejects are more than 5% estimated percentage __________________ ________________ with justification may be given ___________________ _________________ Value (Rs. Lacs) XV. EMPLOYMENT (All figures in number) Existing Proposed -------------- -------------- a) Supervisory Men _______________ _______________ Women_____________ _ .....

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..... he relevant provisions of GST /CGST/SGST / UTGST/IGST Acts of 2017 B. none of the Proprietor / Partner(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 is on the Denied Entity List (DEL) of DGFT; C. 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; D. we have not obtained nor applied for issuance of an Importer Exporter Code Number in the name of our Registered / Head Office or any of our Branch(s) / Units(s) / Division(s) to any other Licensing Authority 2. I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, as amended from time to time, the Rules and Orders framed there under, the Foreign Trade Policy, the Handbook of Procedures and the ITC (HS) Classification of Export & Import Items. 3. I/We hereby declare that the above statements are true and correct to the best of my/our knowledge and .....

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..... t or the proposal is for partial conversion.(Please give details of the existing capacity etc.) b) Whether any expansion of the DTA unit proposed to be converted into EOU has been envisaged, if so the extent thereof.(Please give details of the existing capacity and the enhanced capacity etc). c) What is the level of existing exports of the unit proposed to be converted into EOU. (Please give details of export performance item-wise for a minimum of three previous years) d) Whether the DTA unit is already under obligation to export, under: i) Advance Licensing Scheme; ii) Import of machinery under EPCG scheme; iii) Any other Scheme. (Give all relevant details including total E.O. imposed, the E.O. discharged till date etc.) e) Whether your unit is registered with the Customs/ Excise authorities and GST. (Please give details viz. Reg. No., date etc.) f) Deleted. g) Whether you are a merchant exporter or a manufacturer exporter.(Please give details) h) What is the age(year of manufacture)and residual life of items/ machinery already installed in your unit, whether they are imported or indigenous.(Please attach separate sheets giving item-wise details with value of th .....

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..... _________________________________ Full Address _________________________________ (Regd.Office in case of limited companies & Head Office for others) Pin Code _________________________________ Tel. No. _________________________________ Fax No. _________________________________ Permanent E-Mail Address _________________________________ Web-Site, if any _________________________________ Passport No., if any _________________________________ Name of Bank with Address & A/c No. _________________________________ Digital Signature _________________________________ Income Tax PAN _________________________________ The name and address of each _________________________________ of the Director/Partner II. NATURE OF THE APPLICANT FIRM: [Please tick (√ ) the appropriate entry] Government Undertaking/Public Limited Company/Private Limited Company/Proprietor ship/Partnership/Others (please specify) Note:- Copy of certificate of incorporation alongwith Article of Association and Memorandum in case of companies and partnership deed in case of partnership firms may please be attached. III. INDICATE WHETHER THIS PROPOSAL IS FOR [Please tick (√) the approp .....

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..... _____) (Value (In Rupees) (Not required for service unit) 1st year ___________________ __________________ 2nd year ___________________ __________________ 3rd year ___________________ __________________ 4th year ___________________ __________________ 5th year ___________________ __________________ VII. Indigenous Requirement: (Value in Rupees) a) Capital Goods b) Raw material, components, consumables, packing material, fuel etc. during the period of 5 years TOTAL: ------------------------ ------------------------ VIII. FOB VALUE OF EXPORTS (1 $ = Rs. ) Rupees (lakhs) US $ (Thousand) 1st year 2nd year 3rd year 4th year 5th year Total: IX. INVESTMENT: (RS. IN LAKHS) (a) Land ________________________ (b) Building ________________________ (c) Plant and Machinery ________________________ (i) Indigenous ________________________ (US $ Thousand) (ii) Import CIF value _______________________ (iii) Total (i) + (ii) ________________________ (d) Details of source(s) of finance, (both Indian as well as foreign) for the above investments X. WHETHER FOREIGN TECHNOLOGY AGREEMENT IS ENVISAGED (Please tick ( √ ) the appropriate entry ) Yes _ .....

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..... are more than 5% estimated percentage with justification may be given __________________ ________________ Value (Rs. Lacs) XV. EMPLOYMENT (All figures in number) Existing Proposed -------------- -------------- a) Supervisory Men _______________ _______________ Women_____________ _______________ b) Non-supervisory Men Men _______________ _______________ Women_____________ _______________ XVI. NET FOREIGN EXCHANGE EARNING Average NFE on FOB value of exports in Block period, as per para 6.04 of FTP. ________________ XVII. MARKETING a) Whether marketing tie-up/Buy-back envisaged/finalized(Attach documents, if any) _____________ _____________ Yes No G. C. A. R. P. A. b) Destination of exports (in percentage) _____________ _____________ XVIII OTHER INFORMATION i) Any special features of the project proposal which you want to highlight _________________ (please attach the project report, for new units) ii)(a) Whether the applicant has been issued any Industrial license or LOI/LOP under EOU/ STP/EHTP scheme if so, please give full particulars especially reference number, date of issue, items of manufacture and progress of implementation of each projec .....

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..... reign Trade Policy, the Handbook of Procedures and the ITC (HS) Classification of Export & Import Items. 3. I/We hereby declare that the above statements are true and correct to the best of my/our knowledge and belief. I/We will abide by any other condition, which may be stipulated by the concerned Development Commissioner. I/We fully understand that any Permission Letter granted to me/us on the basis of the statement furnished is liable to cancellation or any other action that may be taken having regard to the circumstances of the case if it is found that any of the statements or facts therein are incorrect or false. An affidavit duly sworn in support of the above information is enclosed. 4. I/We fully understand that any information furnished in the application if found incorrect or false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. 5. I/We hereby declare that 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 there from. 6. I hereby certify that I am authorized to verify and sign this declar .....

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