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Application Form for Served From India Scheme (SFIS) for Net Foreign Exchange earnings in the year 2014-15

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..... v Email ID 2. RCMC Details : i. RCMC Number ii. Valid upto [dd-mm-yyyy] -- -- iii. Issuing Authority iv. Products / Services for which registered in terms of main line of business 3. .....

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..... s which are otherwise considered as having been paid for in free foreign exchange by RBI, under Para 9.53(iv) of FTP (As per Total of col. 6 of Annexure- D) Total (As per Total of col. 6 of Annexure E) 6 Exchange rate of US$ to INR as on 01.04.2015 7 Equivalent Net foreign exchange earned in INR (Net Foreign Exchange earning in US $ X exchange rate) Entitlement = 10% of Net Foreign Exchange earned (Rs) 8 Port of Registra .....

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..... ation furnished in the application if found incorrect or false will render me/us liable fo21r any penal action or other consequences as may be prescribed in law or otherwise warranted. (ii) that under Foreign Trade (Development and Regulation) Act (FTDR Act) 1992, my/our firm / company has not been debarred from undertaking any export import business or activity by way of suspension or cancellation of IEC number. (iii) that my/our firm / company has not defaulted from export obligation under any provisions of FTP and has not been placed under the Denied Entity List (DEL). (iv) that foreign exchange earned on account of services rendered from India alone in terms of Para 9.53 of FTP has been taken into account for this application u .....

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..... -- Email Place: Date: Documents to be submitted: i. One Copy of ANF 3B -2 with Annexures A to E duly filled up and signed ii. CA / ICWA / CS certificate in format given in enclosure to ANF 3B-2 with Annexure A to E. iii. Documentary evidence of earnings in Indian Rupees which are otherwise considered as having been paid for in free foreign e .....

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..... 5. Details of Foreign Exchange Earned for Supply of Service From India to outside India or in India, (as certified in Annexure A to D) and Total expenses/payment/remittances of Foreign Exchange including those incurred on Capital Goods by the IEC holder, relating to service sector in Financial year , (as certified in Annexure E of this Certificate) for the period .. is as under: Category of Service Provider Sl. No. of Appendix 41 of HBP v1 Gross Foreign Exchange earned (in US$) Total expenses/payment/remittances of Foreign Exchange* (in US$) Net Foreign Exchange earned* (in US$) .....

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..... Name of the Signatory Designation Membership No. Official Address Flat/Plot/Block No Street/Area/Locality City State PIN Code Telephone No. Country Code ----- Area Code --------- Phone Number -- .....

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