ANF 4A

For Advance Authorisation (Including Advance authorisation for Annual Requirement) / Advance Release Order (ARO)/ Invalidation letter

[Please see guidelines (given at the end) before filling the application].

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

Products for which registered

4. Type of Exporter (please tick)	( √ )
i. Merchant Exporter
ii. Manufacturer Exporter
iii. Service Provider
iv. Others (please specify)
v. Merchant cum Manufacturer

5. Industrial Registration Details

i. SSI / IEM / LOI or IL Registration Number

ii. Date of Issue

iii. Issuing Authority

iv. Products for which registered

6. Excise Details (For those registered with Central Excise Authority)

i. Excise Registration Number

ii. Issuing Authority

7. Status House Details:

i. EH / SEH / TH / STH / PTH

ii. Certificate Number

iii. Date of Issue

iv. Issuing Authority

v. Valid Upto

8. Application Fee Details

i Amount (Rs)

ii Demand Draft / Bank Receipt / Electronic Fund Transfer No

iii Date of Issue

iv Name of the Bank on which drawn

v Bank Branch on which drawn

9. Total CIF value of Imports applied for

i. In Rupees

ii. In currency of imports

iii. In US $

10. Total FOB / FOR value of Exports to be made, including commission

i. In Rupees

ii. In currency of exports

iii. In US $

11. Value Addition (in %):

12. Port of Registration as per paragraph 4.19 of HBP v1 (for the purpose of imports):

13. i. Application made for Export Product Group:

ii. Application made under which Serial No. of SION:

Application made under Para 4.7 of HBP v1: Yes / No

If reply is “Yes”, whether Adhoc Norms fixed: Yes / No

iii. Application made under Para 4A.25 of HBP v1 (for G&J sector).

14. Details of items to be exported / supplied under the Authorisation

S No	Item Description	Item Technical Characteristics/ Quality etc.	ITC (HS) Code	Quantity	Unit of Measurement	FOB / FOR Value (in Rs)	FOB / FOR value (in freely convertible currency)

15. Details of items sought to be imported duty free under the Authorisation

S No	Item Description	Item Technical Characteristic/ Quality etc.	ITC(HS) Code	Quantity in metric units	CIF Value (in Rs)	CIF value (in freely convertible currency)	Total exemption from Customs duty

16. Details of other materials to be used in the export product and sought to be imported / procured from sources other than the Authorisation on which drawback benefits is to be availed (not to be filled if Drawback benefits are not being claimed)

S No	Imported Item			Indigenously Procured Item
	Name, Technical Characteristics/ Quality etc	Quantity in metric units	CIF Value	Name, Technical Characteristics/ Quality etc	Quantity in metric units	Value

17. Details of Outstanding Export Obligation against Advance Authorisation (s) including Advance Authorisation for Annual Requirements issued already

S No	Authorisation No	Authorisation Date	CIF Value (Rs)	FOB Value (Rs)	%age of EO fulfilled		Expiry Date of EO period
					Qty wise	Value wise

18. Details of exports / deemed supplies (including Intermediate supplies) made in the preceding 3 licensing years

Licensing Year	FOB Value of exports (in Rs Crore)	FOR Value of deemed supplies (in Rs Crore)	Total Export Performance (in Rs Crore)

19. Applicable in case of applications made for Advance Authorisation for Annual requirements (AAL)

i. Entitlement of AAL (Rs)

ii. CIF Value of AAL already obtained (Rs) during the licensing year

20. In case of exports made under Deemed Exports category (except for supplies to Advance Authorisation / EOU/ EHTP / STP / EPCG or intermediate supplies), please furnish

i. Name of the Project Authority

ii. Address of the Project Authority

iii. Supply Order No

iv. Delivery period of Supply

v. Credit under which project is financed

vi. Method by which order is procured (ICB etc.)

21. In case of request for issuance of ARO / Invalidation letter, please furnish

i. Advance Authorisation No

ii. Date of Issue of Advance Authorisation

iii. Name (s) of the Indigenous producer from where items are to be procured

iv. Address (s) of the Indigenous producer from where items are to be procured

v. Regional Authority of the Indigenous producer

vi. Items to be supplied by the Indigenous producer

a. Description of individual items

b. Quantity of individual items to be procured

c. Value of individual items to be procured

22. Address of the factory / premises where the items to be imported are proposed to be used

23. Address of the jurisdictional Central Excise Authority under whose jurisdiction the factory / premises falls

24. In case the items to be imported are to be used by the supporting manufacturer, please furnish

i. Name of the supporting manufacturer

ii. Address of the supporting manufacturer

iii. SSI / LOI / IL regn. no. and date of Supporting Manufacturer

iv. Products endorsed on SSI/IL/IEM

Declaration / Undertaking

1. I/We hereby declare that the particulars and the statements made in this application are true and correct to the best of my / our knowledge and belief and nothing has been concealed or held there from. If found incorrect or false, it will render me / us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.

2. I/We undertake to abide by the provisions of FT(D&R) Act, the Rules and Orders framed there under, the FTP, HBP v1, HBP v2 and the ITC(HS) Classification of Export & Import Items.

3. I / We hereby certify that none of the Proprietor/ Partner(s) / Director(s) / Karta / Trustee of the firm / company, as the case may be, is / are a Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / Company which has come to the adverse notice of DGFT.

4. I/We hereby certify that the Proprietor/Partner(s)/Director(s)/Karta/Trustee, as the case may be, of the firm/company is/are not associated as Proprietor/Partner(s)/Director(s)/Karta/Trustee in any other firm/company which is in the caution list of RBI.

5. I/ We hereby declare that I/we have perused the list of SCOMET items as contained in the Appendix 3 to the Schedule 2 of the ITC (HS) Classifications of Export-Import Items, 2004-09 and that the item(s) exported / proposed to be exported does not fall within this list and that I/ We agree to abide by the provisions of the Policy for export of SCOMET items contained in the Foreign Trade Policy, Schedule 2 of ITC (HS) and the HBP v1, irrespective of the scheme under which the item is exported / proposed to be exported (the underlined portion will be deleted in case an application for export license for SCOMET item is being filed).

6. (Applicable in case of Advance Authorisation applications under paragraph 4.7 of HBP v1only)

a. I/We hereby declare that I / We shall abide by the final fixation of norms by the Norms Committee (NC) and shall pay in cash to the Government Customs duty together with interest (as notified) reckoned from the date of imports till the date of deposit on the inputs imported in excess of the norms fixed by NC.

b. I / We hereby declare that no export proceeds are outstanding beyond the prescribed period as laid down by RBI or such extended period for which RBI permission has been obtained.

7. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the FTP.

Signature of the Applicant Place

Name Date

Designation

Official Address

Telephone

Residential Address

Email Address

Guidelines for Applicants

(Please see paragraphs 4.4, 4.13, 4.14, 4.24A and 4A.25 of HBP v1 relevant to the Scheme under which the application is being filed)

1. Two copies of the application must be submitted unless otherwise mentioned.

2. Each individual page of the application has to be signed by the applicant.

3. RCMC details need not be given if the same have already been updated in the IEC.

4. In case of request for ARO / Invalidation letter, applicant may furnish information in respect of Sl No. 1, 2 & 20 of the application only.

For Advance Authorisation

1. Bank Receipt (in duplicate) / Demand Draft / EFT details evidencing payment of application fee in terms of Appendix 21B.

2. Additional documents required:

1. In case of issue of Advance Authorisation for Annual Requirements:

a. Statement of exports made in the preceding licensing year duly certified by a Chartered Accountant / Cost and Works Accountant in the format given in Appendix 26.

b. Self certified copy of the manufacturing licence of the applicant firm or his supporting manufacturer.

2. Invalidation letter(s) incase of supplies to an advance Authorisation holder. However, in case of switch over from physical exports / deemed exports to intermediate supplies, such invalidation letters can also be furnished at the time of redemption of advance authorisation.

3. In case of Deemed Export:

Project Authority certificate in case of supplies other than (ii) above and to EOU / EHTP / STP / BTP units;

3. In cases where import of fuel has been sought for under Advance Authorisation / Advance Authorisation for Annual Requirements (excluding Advance Authorisation applications for ad-hoc norms and those under Para 4.7 of HBP v1)

a. Self certified copy of the permission issued to the manufacturer exporter by the competent authority (concerned State Electricity Board or Power Corporation or Regulatory Commission of the State) under Section 44 of the Electricity (Supply) Act, 1948 for the installation of captive power plant based on the specified fuel unless the permission is specifically waived by the State Electricity Board; and

b. Self certified copy of the letter intimating the date of commissioning of the captive power plant from the concerned authority which issued the permission letter is to be submitted.

Note: Import of only such fuel(s) shall be allowed which have / has been specified in the said permission.

4. Additional documents required in case of issue of Advance Authorisation under Para 4.7 of Handbook

a. Information as per Appendix-11A,

b. Technical Details of the export product as per the details given in Appendix 33.

c. Chartered Engineer certificate certifying the import requirements of raw materials in the format given in Appendix 32B.

d. Production and Consumption data of the manufacturer / supporting manufacturer of the preceding three licensing years, duly certified by the Chartered accountant / Cost & Works Accountant / Jurisdictional Excise Authority.

5. Please state ‘Not Applicable’ wherever the information / data is not applicable to you.