ANF 3D

For Focus Market Scheme (FMS) Applications

(for exports during 2006-07/2007-08/2008-09)

[ANF 3D amended by 151-PN(RE)/26.02.2009]

(Please note that application for FMS benefits for exports made during 2006-07 and 2007-08 and 2008-09 cannot be clubbed into one application. Separate applications are required to be filed for separate years.)

(Please note that export shipments from all EDI ports can be filed in one application while for export shipments from each Non-EDI ports, separate application is required to be filed.)

1. IEC Number

2. Applicant Details

i. Name

ii. Address

3. RCMC Details
i. RCMC Number	ii. Date of Issue
iii. Issuing Authority	iv. Valid upto
v. Products for which registered

4. Details of exports made during the licensing year _____ (2006-07/2007-08/2008-09) (Write the relevant year as per date of export)*

(Please note that exports made during 2006-07 and 2007-08 and 2008-09 cannot be clubbed into one application)

Sl No	Shipping Bill No	Shipping Bill Date	Date of Export*	Port of Export	ITC (HS) code	Item Description	Focus Market code
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)

FOB value of Exports in free foreign exchange (Inclusive of commissions and discounts, if any)	Customs Rate of Exchange on the date of LEO**	FOB value of Exports in Indian Rupees (Inclusive of commission and discounts, if any)	Rate of Entitlement	Entitlement (in Rs.)	Late cut applicable, if any (in Rs.)	Focus Market Entitlement (in Rs.)
(9)	(10)	(11)	(12)	(13)	(14)	(15)
			2.5%	(13) = (11) X (12)		(15) = (13) – (14)

5. Number of Split Certificates required (in multiples of Rs 5 lakhs each):

(Splits Certificates shall not be allowed for Duty Credit scrips issued for exports from Non-EDI ports)

6. Port of Registration (for the purpose of imports)***:

Note: No supplementary cut shall be imposed, as multiple applications can be filed.

(* Date of Export shall be as per Para 9.12 of HBP v1. No further claims shall be allowed under the scheme against S/Bs included under Sl. No. 4 of ANF 3D, even in case of part realizations.)

(** In case of multiple dates of realization against a shipment, the last date of realization is to be mentioned in this column.)

(*** The port of registration shall be any one of the EDI ports from which the exports have been made. In case of exports from Non EDI port, port of registration shall be the port of export.)

8. Application Submission Details (in case of electronically submitted applications)	9. Application Fee Details
i. ECOM Reference Number	(i) Amount (Rs):
ii. Date of Submission on Server	(ii) Demand Draft / Bank Receipt / Electronic Fund Transfer No
iii. Submitted to which Regional Authority	(iii) Date of Issue
iv. File Number	(iv) Name of the Bank on which drawn
v. Date of Issue	(v) Bank Branch on which drawn

Declaration/Undertaking

1. I hereby declare that particulars and statements made in this application are true and correct and nothing has been concealed or held therefrom. I fully understand that any information furnished in application if found incorrect or false will render my firm / company and me liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.

2. I hereby certify that none of Proprietor/ Partner(s) / Director(s) / Karta / Trustee of firm / company, as the case may be, is a Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / company which has come to adverse notice of DGFT. I further declare that under Foreign Trade (Development and Regulation) Act (FT (D&R) Act) 1992, my firm / company have not been debarred in person from undertaking any export import business or activity by way of suspension or cancellation of IEC number. [If so debarred under FTDR Act, details of said order and period for which the same is operational may be provided].

3. I hereby certify that my firm / company have not defaulted from export obligation under any provisions of FTP and have not been placed under the Denied Entity List (DEL). [If under DEL List, kindly furnish details of order, current status etc.]

4. I hereby declare that details of exports of goods of my firm / company are true and correct and in accordance with accounts maintained in my firm / company.

5. I hereby declare that no benefit under Focus Market Scheme (FMS) was availed (or applied for) previously against Shipping Bills currently included in this application.

6. I hereby declare that in terms of Para 3.12.6 of FTP, this application does not contain any exports for which benefit under any other promotional scheme under Chapter 3 of FTP has been / will be claimed.

7. I further declare that shipment for which benefit is claimed under this application contains only those export shipments exported through EDI enabled ports, and does not contains any shipment from non-EDI ports.

I further declare that shipment for which benefit is claimed under this application contains only those export shipments exported through a single non-EDI enabled ports; and does not contains any shipment from EDI ports or other non EDI ports.

(Strike out which ever is not relevant, as separate applications for shipments from EDI ports and from shipments from each Non-EDI ports are required to be submitted).

8. I hereby declare that in terms of Para 3.12.8 of FTP, this application does not contain any exports in contravention to this provision.

9. I hereby declare that the Export Market is covered under Appendix 37C and the exports, for which this application is being filed, are made on or after the respective admissible date of export, as indicated in Appendix 37C.

10. I hereby declare that export product, for which FMS benefit is being claimed, does not contain any shipment made w.e.f 1.4.2007 from such EOU / EHTP / BTP Units, on which direct tax exemption is/ will be availed and further that these exports are not covered under Sr. No. 11 below.

11. I hereby declare that the exports, for which benefit is being claimed under FMS, does not include any export and / or category covered under Para 3.9.2.2 of FTP for FMS.

12. I hereby declare that the exports, for which benefit is being claimed under FMS, does not include any shipment exported after the itemized policy contained in the ITC HS was restricted or prohibited.

13. I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.9 of FTP.

Place: ____________	Signature: __________________________
Date: _____________	Name: _____________________________
Documents to be submitted	Designation: ________________________
1. Export promotion (EP) copy of Shipping Bill / Bill of Export (including in case of exports through Land Customs)	Official Address: _____________________ ___________________________________
2. Relevant Original Bank Certificate of Exports and Realisation - Appendix 22A / Foreign Inward Remittance Certificates (FIRC) or offsetting of export proceeds with approval of RBI (Appendix 22D). 3. As a proof of landing of export consignment in specified Focus Market, any one of the documents specified in Para 3.20.3 should suffice.	Residential Address: __________________ ___________________________________
4. In case of FIRC, a declaration from exporter that remittance is in respect of Shipping Bill(s) No _______ dtd _______ shall also be furnished.	Telephone: _________________________
In case the application is filed without BRC, the application shall be accompanied with BG / LUT in terms of Paragraph 2.20 of the HBP v1. Detailed guidelines shall be issued shortly. [The Paragraph inserted by 151-PN(RE)/26.02.2009]	Email Address: ______________________
Note 1: Each individual page of application has to be signed. One Copy of ANF3D duly signed in provided space. Copy of Updated Profile in ANF1 only if any changes have taken place and updated, along with Copy of Valid RCMC.
Note 2: In cases where original EP copy of Shipping Bill(s) / Bill of export and/or Bank Realisation Certificates has been submitted under any other scheme of FTP, a self attested photocopy(s) of EP copy of the same be attached, quoting Reference File no. & concerned Regional Authority where original documents have been submitted.