ANF 3H
Application for
Served from India Scheme (SFIS) for Current Financial Year
(for Foreign
Exchange Earned during 2008-09)
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1. IEC Number |
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2. Applicant Details |
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i. Name |
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ii. Address |
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3. RCMC Details |
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i. RCMC Number |
ii. Date of Issue |
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iii. Issuing Authority |
iv. Valid upto |
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v. Products /Services for which registered – in terms of main line of
business. |
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4.
Category of Service Provider (please tick) ( √ ) |
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i. Individual Service
Provider |
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ii. Hotels &
Restaurants and other service Providers in Tourism Sector except Stand-alone
restaurant. |
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iii.
Stand Alone Restaurant |
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iv.
All other Service Providers |
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5. Frequency of Application: Monthly/Quarterly /
Half Yearly / Annually (√ the relevant option)
Note: Applicants are to exercise the option of applying
on Monthly/Quarterly / Half Yearly / Annual basis along with the first
application for the current financial year, and this frequency cannot be changed
for application made on basis of FX earnings of the current financial year
6. Foreign Exchange
Earned for rendering of Service from India to (outside India or
In India) – as per frequency of application in Row 5 above.
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Sl.
No. |
Supply
of Service by Service Provider |
Foreign
Exchange Earned(Rs) |
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1 |
Supply of a ‘service’ from India to any
other country underPara 9.53 (i) of FTP. |
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2 |
Supply of a ‘service’ from India to
service consumer of any other country
in India under Para 9.53 (ii) of FTP. |
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3 |
Supply of a ‘service’
from India through commercial or physical presence in territory of
any other country underPara 9.53 (iii) of FTP. |
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4 |
Supply of a ‘service’ in India relating to
exports paid in free foreign exchange under Para 9.53 (iv) of FTP by Category
of Service Provider 4(ii) i.e. Hotels & Restaurants and other
service Providers in Tourism Sector except Stand-alone restaurant. |
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5 |
Supply of a ‘service’ in India relating to
exports paid in Indian Rupees which are otherwise considered as having being
paid for in free foreign exchange by RBI under Para 9.53 (iv) of FTP by
Category of Service Provider 4(ii) i.e.Hotels &
Restaurants and other service Providers in Tourism Sector except Stand-alone
restaurant. |
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6 |
Supply of a ‘service’ in India relating
to exports paid in free foreign exchange under Para 9.53 (iv) of
FTP by Category of Service Provider 4(i), 4(iii),
and 4(iv) above. |
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7 |
Supply of a ‘service’ in India relating to
exports paid in Indian Rupees which are otherwise considered as having being
paid for in free foreign exchange by RBI under Para 9.53 (iv) of FTP by
Category of Service Provider 4(i), 4(iii), and
4(iv) above. |
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Total (Rs) |
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Entitlement
of SFIS (Rs) = [(5%*(Row 4 + Row 5)) +10%* (Total – (Row 4+ Row5))] |
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6. Port of Registration
(for purpose of Imports):
7. Number of Split Certificates required (in multiples of Rs 5 lakhs
each):
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8.
Application Submission Details (in case of electronically submitted
applications) |
9.
Application Fee Details |
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i. ECOM Reference
Number |
(i) Amount (Rs): |
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ii. Date
of Submission on Server |
(ii)
Demand Draft / Bank Receipt / Electronic Fund Transfer No |
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iii.
Submitted to which Regional Authority |
(iii)
Date of Issue |
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iv. File
Number |
(iv)
Name of the Bank on which drawn |
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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 (FTDR 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 has not defaulted from export
obligation under any provisions of FTP and has 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 services of my firm /
company are true and correct and in accordance with accounts maintained in my
firm / company.
5. I hereby certify that foreign exchange earned on account of services
rendered from India alone has been taken into account for this application
under SFIS and these do not fall under any category or service which are not
eligible as per Para 3.18.1 of HBP v1.
6. I further declare that other sources of foreign exchange earnings such
as equity or debt participation, donations, repayment of loans and any other
inflow of foreign exchange unrelated to service rendered has not been
considered.
7. I hereby declare that benefits are being claimed for only those earnings
in Indian Rupees which are otherwise considered as having been paid for in free
foreign exchange by RBI.
8. I hereby undertake to submit to Regional Authority (with a copy to
jurisdictional Excise Authorities), a statement of imports made under
SFIS within one month of completion of imports or expiry of validity of
duty credit scrip, whichever is earlier.
9. I hereby undertake that imports to be made under this duty credit scrip
shall be related to any service sector business and I further undertake that
such imported goods shall not be sold / transferred / disposed off in a manner
in contravention to provisions of FTP. I further undertake to abide by
provisions of Para 9.53 of FTP relating to supply of service from India.
10. I undertake to abide by provisions of FTDR Act, 1992, Rules and Orders
framed thereunder, and FTP.
11. I hereby certify that I am authorized to verify and sign this
declaration as per Paragraph 9.9 of FTP.
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Place:
____________ |
Signature: _______________________ |
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Date:
_____________ |
Name: _____________________________ |
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Documents
to be submitted |
Designation:
_________________________ |
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1. Documentary evidence for payment
of Application Fee |
Official Address:
_____________________ ______________________________________ |
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2. CA / ICWA / CS certificate in
format given in annexure to ANF 3B. |
Telephone: _________________________ |
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3. Documentary evidence of earnings
in Indian Rupees which are otherwise considered as having been paid for in
free foreign exchange by RBI should be produced. |
Residential Address:
__________________ ______________________________________ |
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Note: Each page of application has to be signed. |
Email Address:
________________________ |
Annexure to ANF 3H
Certificate of
Chartered Accountant (CA)
Cost and Works Accountant (ICWA)/ Company
Secretary (CS)
I hereby confirm that I have examined
prescribed registers and also relevant records of M/s.…… ………… …………………having IEC
number…………………… for period ………………… of the current financial year 2008-09 (as per
the frequency of application, please specify the month/quarter/half year/annum)
and hereby certify that:
(i) Following documents / records have been
furnished by applicant individual / firm / company and have been examined and
verified by me / us namely: -
Bills, Invoices, Forward Inward Remittance
Certificates (FIRCs), Bank Realization Certificates, Certificate from
international credit card companies, and evidences of foreign exchange
earnings as well as the connected books of accounts.
(ii) Relevant
accounting and financial register(s) as prescribed under different Acts and
Rules made there under have been maintained and authenticated under my / our
seal and signature.
(iii) Information
given by applicant in ANF 3H including details on Services rendered From India
as per Appendix 10 of HBP v1 (with relevant sr. no. and description) is true
and correct.
(iv) Services
for which benefits is claimed does not include ineligible services and
remittances as listed under Para 3.18.1 of HBP v1.
(v) It
has been ensured that information furnished is true and correct in all
respects; no part of it is false or misleading and no relevant information has
been concealed or withheld;
(vi) Neither
I, nor any of my / our partners is a partner, director, or an employee of
above-named entity, its Group companies or its associated concerns;
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Place:
______________ |
Signature of
CA/ ICWA / CS:_______________________ |
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Date:
_______________ |
Name of the Signatory:
______________________ |
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Address:
_________________________________ _________________________________________ |
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Membership No:
___________________________ |
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Email Address:
_________________________________ |
(vii) Certificate of Foreign Exchange Earned by
Supply of Service from India to (outside India or In India) is as under:
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Certificate of Foreign Exchange Earned by Supply
of Service from India to (outside India or In India) For the period ………………. (as
per the frequency of application, please specify the month/quarter/half
year/annum of the current financial year 2008-09) |
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Sl. No. |
Category of Service Provider |
Sl. No. of Appendix 10 |
Foreign Exchange Earned |
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1 |
Para 9.53 (i) |
i) … |
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2 |
Para 9.53 (ii) |
i) ii) … |
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3 |
Para 9.53 (iii) |
i) … |
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4 |
Para 9.53 (iv) for
Category 4(ii) of Sr. No 5 of ANF 3B |
i) ii) …. |
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5 |
Para 9.53 (iv) for
Category 4(i), 4(iii), 4(iv) of Sr. No 5 of ANF 3B |
i) ii) … |
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6* |
Para 9.53 (iv)* for
Category 4(ii) of Sr. No 5 of ANF 3B |
i) ii) …. |
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7* |
Para 9.53 (iv)* for
Category 4(i), 4(iii), 4(iv) of Sr. No 5 of ANF 3B |
i) ii) … |
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Total Foreign Exchange Earned by Supply of
Service from India to (outside India or In India) (Rs) |
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*Earnings in Indian
Rupees that are otherwise treated as deemed to be realized in free foreign
exchange by RBI – See Para 9.53 (iv) of FTP. |
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(vii) I
fully understand that any statement made in this certificate, if proved
incorrect or false, will render me liable to face any penal action or other
consequences as may be prescribed in law or otherwise warranted.
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Place: ______________ |
Signature
of CA/ ICWA / CS:_______________________ |
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Date: _______________ |
Name
of the Signatory: ______________________ |
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Address:
_________________________________ _________________________________________ |
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Membership
No: ___________________________ |
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Email
Address: _________________________________ |