TaxTMI 
TaxTMI 
Bill of Export For Goods Under Claim For Duty Drawback
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.... 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 [ ] 8. Letter of Credit [ ] 9. QC Ce....
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....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. Any other (Specify) [ ] Item No. in B/E S. No. & Sub S. No. of DBK Schedule Qty./Wt. On which DBK Claimed Value on which DBK claimed Rate of DBK Amount of DBK Excise Customs Excise Customs Total Total Amount in words : Rupees ……&he....
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....;…………………. 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 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 which Drawback Rates are applicable. 1. Name and Address of Bank …………………………..……………&hell....
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....;………….(Rupees……………………………………………………..) Dealing Clerk Officer Examination Order and Report 1ANNEXURE V (See regulation 3) BILL OF EXPORT FOR GOODS UNDER CLAIM FOR DUTY DRAWBACK EXPORT PROMOTION COPY Quadruplicate 2[Exporter, whether Government or Private] Invoice No. & Date BE 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 Lorry No./goods Train & Wagon No. Originating From Type of Shipment : Outright Sale [ ] Consignment Export [ ] Others (Specify) [ ] Land Cus. Station Nature of Contract : CIF [ ] / CFR [ ] / FOB [ ] Other (Specify) [ ] Place of Delivery Country of Destination Exchange Rate U/S 14 of CA Currency of Invoice S. No. Marks & Nos. No. & Kind of Pkgs. Container Nos. 2[Statistical C....