APPLICATION FORM FOR APPROVAL FOR EXPORT OF SCOMET ITEMS FROM STOCKIST ENTITY TO END USER

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..... iv. Tele No. (1) Country Code Area Code Tele. No. (2) .....

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..... s) File Number Category Description 4. Shipment Details i. Port of Lading/Shipment ii. Port of Discharge iii. Country to which item to be exported iv. Ultimate Destination Country 5. Purpose of Export i. Re-export of Stocked .....

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..... vi. Export Order No. and Date 6B. Consignee Details i. Name ii. Address Flat/Plot/Block No. Street/Area/Locality City Country Postal Code iii. Telephone No. (1) Country Code Area Code Tele. No .....

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..... iv. Fax No. Country Code Area Code Fax No. v. E-mail v .....

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..... 9. Application Submission Details (if submitted electronically): i. ECOM Reference Number ii. Date of Submission on Server iii. Submitted to which Regional Authority iv. File Number Date of Issue v. Application Fee submission details viz. Amount in Rupees, Demand Draft No./Electronic Fund Transfer No. and Date and the name branch of the bank on which drawn 9B. Jurisdictional Regional Authority of original 'Stock Sale' authorization: DECLARATION/UNDERTAKING 1. I / We .....

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..... r is in the caution list of RBI; C. Neither the Registered Office Of the company / Head Office of the firm / 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 neither obtained nor applied for issuance of an Importer Exporter Code Number in the name of our Registered / Head Office to any Other Licensing Authority. (v) I / We hereby declare that I / We have neither obtained nor applied such benefits (including issuance of an Importer Exporter Code Number) in the name of our Registered / Head Office or any of our Branch(s) / Unit(s) / Division(s) to any other Regional Author .....

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