EXCHANGE CONTROL DECLARATION (GR) FORM NO.

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....ncy of invoice S.No Marks & No. No. & Kind of Pkgs. Statistical Code & Description of Goods Quantity Value FOB Container Nos. Net Weight 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 Currency Commission Rate Discount Amount Other Deductions 2 EXCHANGE CONTROL DECLARATION (GR) FORM NO. Is Export under L/C arrangements? Yes [ ] No [ ] FOR CUSTOMS If yes, name of advising bank in India Customs Assessable value Rs. (Rupees . ........................................................................................ Bank through which payment is to....

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.... applicable SPACE FOR USE BY RESERVE BANK OF INDIA EXCHANGE CONTROL DECLARATION (GR) FORM NO. Duplicate Exporter Invoice No.& Date SB No.& Date AR4/AR4A No.& Date Q/Cert No.& Date Importer-Exporter Code No. Consignee Export Trade Control If export under: Deferred Credit [ ] Joint Ventures [ ] Rupee Credit [ ] Others [ ] RBI's Approval/Cir.No. & Date Custom House Agent L/C.No. Pre-Carriage by Place of Receipt Type of shipment : By Pre-Carrier Outright Sale [ ] Consignment Export [ ] Vessel/Flight No. Rotation No. Others [ ] (Specify) Port of Loading Nature of Contract:CIF[ ]/C&F [ ]/FOB [ ] Other (Specify) [ ] Port of Discharge Country of Destination Exchange Rate U/S 14 of CA Currency of invoice S.No ....

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....We undertake that I/We will deliver to the bank named herein the foreign exchange representing the full export value of the goods on or before @ ................................... in the manner specified in the Regulation made under the Act. I/We further declare that I/We am/are resident in India and I/We have a place of business in India. I/We* am/are OR am/are not in Caution List of the Reserve Bank of India. ...................................... Date................ (Signature of Exporter) @ State appropriate date of delivery which must be within six months from the date of shipment, but for exports to warehouses established outside India with the permission of the Reserve Bank, the date of delivery must be within fifteen months. ....