ANF 4 H

Duty Free Import Authorisation (DFIA) Application

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

[ANF 4H amended by 43-PN(RE)/04.07.2008]

Application for:	(please tick) ( √ )
i. Pre-Export DFIA (Form I)
ii. Post Export DFIA (Form I)
iii. Redemption / Transferability (Form II)

Form I

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. 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 / Others

ii. Certificate Number

iii. Date of Issue

iv. Issuing Authority

v. Valid Upto

8. Application Fee Details

Amount (Rs)

Demand Draft / Bank Receipt / Electronic Fund Transfer No

Date of Issue

Name of the Bank on which drawn

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 ( for the purpose of imports ):

13.

i. Application made for Export Product Group:

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

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

15. Details of items sought to be imported duty free under the Authorisation
S No	Item Descrip-tion	Item Technical Characteristics/ Quality etc.	ITC(HS) Code	Quantity	Unit of Measure-ment	CIF Value (in Rs)	CIF value (in freely convertible currency)		Total exemption from Customs duty
S No	Item Descrip-tion	Item Technical Characteristics/ Quality etc.	ITC(HS) Code	Quantity	Unit of Measure-ment	CIF Value (in Rs)	Value	Currency Code

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
S No	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 DFIA, 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
S No	Authorisation No	Authorisation Date	CIF Value (Rs)	FOB Value (Rs)	Qty wise	Value wise	Expiry Date of EO period

18. Details of exports / deemed 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. In case of exports made under Deemed Exports category (except for supplies to Advance Authorisation/DFIA/ EPCG Authorisation holders/EOU/EHTP/STP/BTP), 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.)

20. In case of request for issuance of Invalidation letter/ ARO:
I. Request is for issuance of:	(Please tick): ( √ )
A. Invalidation letter
B. Advance Release Order (ARO)

If so, then please furnish the following details: (i and ii below need not be filled up in case the applicant desires the Invalidation Letter/ARO along with the issuance of DFIA)

i. Duty Free Import Authorisation No.

ii. Date of Issue of Duty Free Import Authorisation

iii. Name of the Indigenous producer / STE from where items are to be procured

iv. Address of the Indigenous producer / STE from where items are to be procured

v. Regional Authority of the Indigenous producer / STE

vi. Items to be supplied by the Indigenous producer / STE

a. Description of individual items

b. Quantity of individual items to be procured

c. Value of individual items to be procured

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

23. 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. I / We hereby declare that we shall only import inputs which are required for the manufacture of the export product(s) and no part of it shall be sold/transferred/disposed off unless the DFIA is made transferable or utilised in a manner in contravention to the provisions of the Policy and Handbook.

7. 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.

8. 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 4.55 of HBP v1]

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 Post Export DFIA application, details of Col. 21, 22 and 23 (iii) and (iv) are not required.

5. Application must be accompanied by documents as per details given below:

V. For Duty Free Import Authorisation

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

2. In cases where import of fuel has been sought for the grant of Duty Free Import Authorisation:

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

6. Additional documents required in case of supplies under deemed export / intermediate supplies under DFIA:

a. Invalidation letter in case of supplies to

i. an EPCG Authorisation holder;

ii. an Advance Authorisation holder;

iii. a Duty Free Import Authorisation

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 DFIA.

b. Project Authority certificate in case of supplies other than (a) (i), (ii) & (iii) above and to EOU/ EHTP/ STP/BTP units;

7. FOB value of export for the purpose of V.A shall be arrived at after excluding the Agency Commission, if any. This provision shall be applicable for authorizations issued on or after 1.4.2008

Form II

Redemption of DFIA / Endorsement of Transferability on DFIA.

1. Request is for: (Please Tick )
i. Redemption of DFIA
ii. Transferability of the DFIA

i a. Authorisation File Number
I b. Date of Issue
i c. Authorisation Number
I d. Date of Issue
ii. CIF Value
a. In Indian Rupees
b. In free foreign exchange
iii. Export Obligation imposed
a. In Indian Rupees
b. In free foreign exchange
Iv a Date of expiry of initial export obligation period
iv b. Date of expiry of extended export obligation period
v. Product exported
Vi a. Serial Number of SION (in case of fixed norms)
Vi b. Reference number and date vide which norms have been ratified (applicable only in case of advance authorisation issued under para 4.7)

2. Application Fee Details (in case of enhancement of CIF value etc.)

Amount (Rs)

Demand Draft/Bank Receipt/Electronic Fund Transfer No

Date of Issue

Name of the Bank on which drawn

Bank Branch on which drawn

3. Details of physical exports / deemed exports made

Sl. No.

S. Bill / Invoice Details

Port of Export

Let Export order date

FOB / FOR Value

Quantity of Export

Unit of Measure-ment (UOM)

BRC Details

No.

Date

In Rs

In FFE

In US $

No.

Date

Bank & Branch

FOB Value

In Rs.

In FFE

In US $

4. Shipping Bill / Invoice Wise Export items details:

Sl. No.	Type of Export (EDI/ Non-EDI)	ITC(HS) Code	S. Bill NO.	Invoice No.	Invoice Sl. No.	Export Product Group	SION No.	Export Product Sl. No.	Quantity Exported / Supplied
									Direct Export	Third Party Export	Deemed Exports/ Interme-diate supplies	Total	U /M
1	2	3	4	5	6	7	8	9	10	11	12	13	14

Foreign Currency (FC)			FOB Value			FOR Value		BRC Details
FFE Name	FFE Conv. Rate	Eqv. US $ / Rs. Rate	In FFE	In Rs.	Eqv. US $	In Rs.	Eqv. US $	FFE Conv. Rate	Eqv. To US $ Rate	In FFE	In Rs.	Eqv. US $
15	16	17	18	19	20	21	22	23	24	25	26	27

5. Details of imports made against the Authorisation ( In case of Pre-Export DFIA)

Sl. No	Item of Import	Qty allowed in the Authorisation	CIF Value allowed in the Authorisation (in FFE)	Bill of Entry Details		Quantity imported	CIF Value (in FFE)
Sl. No	Item of Import	Qty allowed in the Authorisation	CIF Value allowed in the Authorisation (in FFE)	No	Date	Quantity imported	CIF Value (in FFE)

6. Details of excess imports made proportionate to the export obligation fulfilled (Please fill if applicable):

Sl. No	Item of Import	Bill of Entry Details		Quantity	Duty Details
		No	Date		Customs Duty	Interest	Total

Declaration / Undertaking

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.

6. 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 4.70 & 4.72 of HBP v1]

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. Application must be accompanied by documents as per details given below:

a. For physical exports:

1. Bank Certificate of Exports and Realisation in the form given at Appendix 22A or Foreign Inward Remittance Certificate (FIRC) in the case of direct negotiation of documents or Appendix 22D in case of offsetting of export proceeds. However, realisation of export proceeds shall not be insisted if the shipments are made against confirmed irrevocable letter of credit or bill of exchange is unconditionally Avalised/ Co- Accepted/ Guaranteed by a bank and the same is confirmed by the exporters bank and certified by the bank in column 14/15 of Appendix 22A. For status holders, irrevocable letter of credit would suffice.

2. EP copy of the shipping bill(s) containing details of shipment effected or bill of export in case of export to SEZ.

3. A statement of exports giving details of shipping bill wise exports indicating the shipping bill number, date, FOB value as per shipping bill and description of export product

4. A statement of imports indicating bill of entry wise item of imports, quantity of imports and its CIF value.

b. For deemed exports:

1. A copy of the invoice or a statement of invoices duly signed by the unit receiving the material and their jurisdictional excise authorities certifying the item of supply, its quantity, value and date of such supply. In no case,such endorsement by the central excise authority shall exceed 21 days from the date of delivery of such supply. However in case of supply of items which are non excisable or supply of excisable items to a unit producing such supply non excisable product(s), a Project Authority Certificate (PAC) certifying quantity, value and date of supply would be acceptable in lieu of excise certification. However, in respect of supplies to EOU/EHTP/ STP/ BTP, a copy of CT-3/ARE-3 duly signed by the jurisdictional excise authorities certifying the item of supply, its quantity, value and date of such supply can be furnished in lieu of the excise attested invoice (s) or statement of invoices as given above.

2. Payment certificate from the project authority in the form given in Appendix-22C. In the case of Advance Authorisation for Intermediate Supplies/ deemed exports, supplies to the EOUs/ EHTPs/STPs/ BTPs, documentary evidence from the bank substantiating the realisation of proceeds from the Authorisation holder or EOUs/EHTPs/ STPs/ BTPs, as the case may be, through the normal banking channel, shall be furnished in the form given at Appendix 22B. However realisation of proceeds shall not be insisted upon if the shipments are made against confirmed irrevocable inland letter of credit or inland bill of exchange is unconditionally Avalised/ Co- Accepted/ Guaranteed by a bank and the same is confirmed by the exporters bank and certified by the bank in column 5/6/7 of Appendix 22B. For status holders, irrevocable inland letter of credit would suffice.

3. A statement of supplies giving details of supply invoices and indicating the invoice number, date, FOR value as per invoices and description of product

4. A statement of imports indicating bill of entry wise item of imports, quantity of imports and its CIF value.

5. Declaration in Appendix 23 format related to consumption of the inputs endorsed in the DFIA.