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

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..... State PIN Code iv. Tele No. (1) Country Code Area Code Tel No. (2) .....

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..... 3. Details of exports of stocked items made previously Sl.No. Approval no. Date Details of items to be exported Quantity exported Country which the item is to be exported DGFT s HQ File number Category Description 4. Shipment Details: i. Port of Loading/Shipment ii. Port to Discharge iii. Country to which item to be .....

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..... iv. Fax No. Country Code Area Code Fax No. v. E-mail vi. Export Order No. and date .....

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..... vi. E-mail 6C. End User Details : (If same as Foreign Buyer and/or Consignee write SAME As in 6A and/or 6B as the case maybe) i. Name Flat/Plot/Block No. Street/A .....

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..... bmission 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 hereby certify that: (i) I/We hereby declare that the particulars and the statements made in this application are true and correct to the best of my I/our knowledge and belief and nothing has been concealed or held there from. (ii) I/We fully understand that any information furnished in the application if found incorrect or false will render me liable for any penal action or other consequenc .....

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..... Registered I Head Office to any other Licensing Authority. (v) I/We hereby declare that I/We have neither obtained nor applied for such benefits (including issuance of an Importer Exporter Code Number) in the name of our Registered I Head Office or any of our Branch(s) Unit(s) Division(s) to any other Regional Authority. (vi) We have complied with the conditions of all previous licences/authorizations issued to us for export of SCOMET items and wherever required have duly intimated the J/o DGFT, New Delhi along with documentary evidence regarding receipt of the items of export by the end-user within the stipulated time. (vii)I/We undertake to abide by the provisions of the FT(D R) Act, 1992, as amended, the Rules and Orders framed .....

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