TaxTMI 
TaxTMI 
Shipping Bill For Export Of Goods Under Claim For Duty Drawback
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....t Gross Weight Total FOB Value in words Analysis of Export Value Currency Amount Full export value OR where not ascertainable, the value which exporter expects to receive on the sale of goods. FOB Value Freight Insurance Rate Commission Currency…………………… Discount Amount ……………………. Other Deductions S. No. Export Tariff No. Assessable Value under Sec. 14 of CA Duty Cess Total Duty & Cess Duty payment particulars Rate Amount Rate Amount Total Duty/Cess Amount in words : Rupees Collection Stamp Declaration : I/We declare that all particulars given herein are true and correct. I/We also attach the declaration(s) under clause No.(s)……………….. Public Notice No................Dated................. Signature of Exporter/ CHA…………………. & Date Original DOCUMENTS SUBMITTED 1. Invoice [ ] 2. Packing List [ ] 3. GR Form [ ] 4. AR-4 / AR-4A Form [ ] 5. ETC Licence [ ] 6. Indent [ ] 7. Acceptance of Contract ....
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....s, 1971. I/We certify that the export goods are new/used for ……………….. I/We certify That I/We have complied with the conditions subject to which Drawback Rates are applicable. DOCUMENTS SUBMITTED 1. Invoice [ ] 2. Packing List [ ] 3. GR Form [ ] 4. AR-4 / AR-4A Form [ ] 5. ETC Licence [ ] 1. Name and Address of Bank ……………………....…....... 6. Indent [ ]  ……………………………………………………….....… 7. Acceptance of Contract [ ]  ………………………………………………………....… 8. Letter of Credit [ ] 2. Account No. ……………. 3. DBK Ledger No.………..... 9. QC Certificate [ ] 10. Port Trust Document [ ] 11. Any other (Specify) [ ] Item No. in B/E S. No. & Sub S. No. of DBK Schedule Qty./Wt. On which ....
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....o receive on the sale of goods. FOB Value Freight Insurance Rate Commission Currency…………………… Discount Amount ……………………. Other Deductions S. No. Export Tariff No. Assessable Value under Sec. 14 of CA Duty Cess Total Duty & Cess Duty payment particulars Rate Amount Rate Amount Total Duty/Cess Amount in words : Rupees Collection Stamp Declaration : I/We declare that all particulars given herein are true and correct. I/We also attach the declaration(s) under clause No.(s)……………….. Public Notice No................Dated................. Signature of Exporter/ CHA…………………. & Date Triplicate I/We claim drawback of Rs. ………………….. under Sec. 74/75 of Customs Act, 1962 and Customs and Central Excise Duty Drawback Rules, 1971. I/We certify that the export goods are new/used for ……………….. I/We certify That I/We have complied with the conditions subject to....
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....ssed for Rs. …………… Inspector (Audit) Supdt./AC Claim Registration No. ………………..Issued Cheque No. …………………Dated ……………………… For Rs. ……………………………….(Rupees……………………………………………………..) Dealing Clerk Officer Examination Order and Report 1ANNEXURE I (See regulation 2) SHIPPING BILL FOR EXPORT OF GOODS UNDER CLAIM FOR DUTY DRAWBACK EXPORT PROMOTION COPY Quadruplicate 2[Exporter, whether Government or Private] Invoice No. & Date SB No. & Date AR4 /AR4A No. & Date Consignee Q/Cert. No. & Date 2[Import-Export Code No. and BIN] 2[State of Origin of goods] Export Trade Control If export under : Custom House Agent LIC No. Deferred Credit [ ] Joint Ventures [ ] Rupee Credit [ ] Others [ ] RBI's Approval/Cir. No. & Date Pre-Carriage by Place....