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APPLICATION FOR CLAIM OF TED REFUND / DUTY DRAWBACK / BRAND RATE FIXATION

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....awback as per AIR iii. Fixation of brand rate for duty draw back 6. Application is made by: (i) Supplier of goods (ii) Recipient of goods 7. Supply details: i. Description of goods ii. Category of supplies under Para 7.02 of FTP 8. If application is for refund on TED Sl. No. Inv. No. Date of Description of item(s) of supply Quantity Quantum of TED Late cut, if any Net claim Supply Payment (Provision to be made to add multiple invoices) 9. If the application is for drawback as per AIR under drawback schedule: Sl. No. Invoice No. Date of Description of item(s)of supply Tariff No. FOR value Net quantity of supplies Draw back Rate Supply Payment Value Cap (if any) Amount of DBK Late cut, if any Net payable amount (Provision to add multiple supply Invoices) 10. If supply towards discharge of export obligation to Advance Authorisation Holder against Invalidation letter and drawback is claimed on inputs either imported or procured locally on payment of basic custom duty: Whether, in the application for Advance Authorisation for intermediate supply, it was declared that such inputs to be procured locally /imported on payment of bas....

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....l only be taken into account for such claim. A separate work sheet as per DBK form II, and II(A) and certificates attached thereto duly certified by Chief Executive/production in-charge shall be submitted, as given in the APPENDIX-7E 23. Check List of documents to be attached duly scanned or submitted in the physical form at counter: (1) (a) Copy of Invoices or a statement of invoices duly signed by the units receiving the excisable goods and attested by Central Excise Authorities, as per the procedure prescribed by CBEC in their circular 15/2008-Cus. dated 26.9.2008. To facilitate attestation by Central Excise Authorities, intimation regarding receipt of goods should be given to the said authorities within 48 hours of receipt of goods. Corresponding ER-1/ER-3 or a monthly statement confirming duty payment attested by excise Authorities or Invoices/statement of Invoices certified by Jurisdictional Central Excise Authority of recipient. (b) In case of supply of non-excisable goods, copy of Tax invoices as prescribed under GST Rules or a statement of invoices duly signed by the units receiving the goods and attested by Jurisdictional Customs Authorities, as per the procedure pres....

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....us is not a matter of right and I/we shall immediately refund the amount of TED/drawback obtained by us in excess of any amount/rate which may be re-determined by concerned RA/DGFT/Government as a result of post verification/ Audit objection or otherwise. 4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI. 5. None of the Proprietor/Partners(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 under the adverse notice of DGFT or is in the caution list of RBI, to the best of my knowledge. 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 AD/RBI permission has been obtained. 7. I/we further declare that the goods supplied are excisable goods but no CENVAT credit is availed/ available to the recipient of goods. (In case of items covered under schedule 4 of the central excise Act 1944). 8. I/we further declare that no CENVAT credit facility has been availed on inputs....

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.... Commissioner of the Central Excise Division for cross verification. ANNEXURE-III DISCLAIMER CERTIFICATE FOR NOT CLAIMING DEEMED EXPORT BENEFITS We hereby declare that we have neither drawn nor will draw any benefit of deemed export on supply of goods as declared/to be declared in the application for claim of deemed export benefits and we have no objection if M/s…… (Name and address of the recipient/supplier, as the case may be) draws the deemed export benefits on such supply of goods as mentioned in the application. (Either party will have to give disclaimer in favour of other for not claiming benefits of deemed export against supply of goods as declared in the Application for claim. The disclaimer is to be submitted on the letter head of the firm/company) Yours faithfully, Signature (Authorized Signatory) Full Name Designation Name of the company Telephone Number E-mail Address Fax No. ANNEXURE-IV FORMAT OF CERTIFICATE TO BE ISSUED BY PUBLIC SECTOR OIL COMPANIES CERTIFYING AMOUNT OF TED PAID BY EOU / PROJECT ON PURCHASE OF HSD FROM THEIR DEPOTS: I _________ (name of authorized signatory of PSU Oil Company) hereby declare that we (name of the Company)....

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....any Net claim Supply Payment (Provision to be made to add multiple invoices) 9. If the application is for drawback as per Col. "A" of AIR under drawback schedule: Sl.No. Invoice No. Date of Description of item(s) of supply Tariff No. FOR value Net quantity of supplies Drawback Rate Value Cap (if any Amount of DBK Late cut, if any Net payable amount Supply Payment (Provision to add multiple supply Invoices) 10. If supply towards discharge of export obligation to Advance Authorisation Holder against Invalidation letter and drawback is claimed on inputs either imported or procured locally on payment of duty: Whether, in the application for Advance Authorisation for intermediate supply, it was declared that such inputs to be procured locally /imported on payment of duty? Yes/No 11. 1[ If answer to Col. No. 10 is yes, Advance Authorization no. & date and File. no. under which it was issued. ] 12. Whether claim is made within the prescribed time 13. If not, rate of late cut as per Para 9.02 of HBP 14. If claim for refund of TED is made by supplier: Whether CENVAT credit has been availed by recipient? 15. If claim for refund of TED is made by recipient: ....

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....of invoices attested by Central Excise Authorities, as per the procedure prescribed by CBEC in their circular 15/2008-Cus dated 26.9.2008. To facilitate attestation by Central Excise Authorites, intimation regarding receipt of goods should be given to the said authorities within 48 hours of receipt of goods. Corresponding ER-1/ER-3 or a monthly statement confirming duty payment attested by excise Authorities or Invoices/statement of Invoices certified by Jurisdictional Central Excise Authority of recipient. (2) In case supply of goods to EOU, ARE-3 duly certified by the recipient and their jurisdictional Central Excise Authority. (3) Self certified copy of B/Es (4) Proof of payment through e-BRC as per APPENDIX-2U or Payment Certificate issued by Project Authority in APPENDIX-7D in original, as the case may be. (5) PAC issued by the Project Authority in original as per APPENDIX-7C or File No. where the original has been submitted. (6) 2[ Copy of contract if supplies were made to Project Authority or supplier's copy of original ARO or recipient's copy of original Invalidation Letter, (If supply against ARO/Invalidation Letter issued against AA/DFIA/EPCH, as the case may....

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.... verify and sign this declaration as per Paragraph 9.06 of the FTP. Place: Signature of the Applicant Date: Name Designation Official Address Telephone Residential Address Email Address ANNEXURE-I DECLARATION FOR CLAIMING BENEFIT OF TERMINAL EXCISE DUTY (TED) It is certified that no CENVAT credit under the Central Excise Rules has been availed by us, nor will be availed in future, on supply of these items as per the application. Signature (Authorized Signatory): Full Name: Designation: Name of the company: Telephone Number: E-mail Address: Fax No: Note: To be given on the letter head of the recipient of goods. ANNEXURE-II DECLARATION FOR CLAIMING DEEMED EXPORT DRAWBACK 1. I, (Name & Designation) …..on behalf of M/s. ….. (Name and address of the supplier) hereby certify that we have supplied the following goods to M/s….. (Name and address of the recipient): S. No. Inv. No. & date Description of goods Unit Qty. Value 2. We are the manufacturer exporters/suppliers and are registered/not registered with Central Excise Authority and have not availed and will not avail CENVAT credit facility in respect of duty paid on inputs/components a....

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....____as per details given below. Description Invoice No. Invoice Date Quantity Value Total Duty paid (with breakup of components) Disclaimer Certificate: We hereby certify that we are not claiming any deemed export benefits on the above supplies and we do not have any objection if _______(Name of EOU/Project) claims deemed export benefits. Authorized Signatory (With full name and Designation)" 4. Substituted vide PUBLIC NOTICE No. 18/2015-2020 dated 23-09-2020 before it was read as "3[ANF-7A APPLICATION FOR CLAIM OF TED REFUND / DUTY DRAWBACK / BRAND RATE FIXATION (Please tick whichever is applicable) (Application shall be filed online once the software is ready) 1. IEC No Branch Code: 2. Applicant details: (i) Name of the firm/company (ii) Full address (iii) Contact Number (iv) E-mail address 3. Bank's details: (i) Name of the Bank (ii) Address of the Bank (iii) IFSC code (iv) Nature of account(SA/CA) (v) A/c Number (vi) Telephone / Fax No. 4. (a) Excise Authority details: (i) Excise Registration No (ii) Address of the jurisdictional Central Excise Authority (iii) Contact details of Excise Authority (iv) Amount of excise duty paid du....

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.... co-product Net wt. of the material Remarks Qty. Sale value per unit 9 10 11 12 13 22. Statement of inputs/components used, either imported or imported materials procured locally ** S.No Description Technical characteristics S.No. in DBK-I statement B/E /Invoice No & date under which imported/procured Name of the Customs House/Excise Authority Unit Qty. imported/procured locally Assessable value 1 2 3 4 5 6 7 8 9 Heading No. in Customs Tariff Act, 1975 Country from which imported / name of supplier Name and full address of the supplier in case the foreign material/ Components obtained locally Rate of Duty Is assessment final Total amount of duty paid (basic custom duty) Remarks 10 11 12 13 14 15 16 ** Only inputs which were imported/ procured and consumed during the period commencing 90 days prior to the date of supply(s) shall only be taken into account for such claim. A separate work sheet as per DBK form II, II(A), and certificates attached thereto duly certified by Chief Executive/production in-charge shall be submitted, as given in the APPENDIX-7E 23. Check List of documents to be attached duly scanned or submitted in the physical....

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....s, as per ANNEXURE-II. (10) Statement of supplies for Fixation of Drawback Rate as per APPENDIX-7E. 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 F.T. (D&R) Act, the Rules and Orders framed there under, the FTP, HBP, SION and the ITC(HS) Classification of Export & Import Items. 3. I/we further declare that the claim made by me/us is not a matter of right and I/we shall immediately refund the amount of TED/drawback obtained by us in excess of any amount/rate which may be re-determined by concerned RA / DGFT/Government as a result of post verification/Audit objection or otherwise. 4. None of the Proprietor/Partners(s)/Director(s)/Karta/Trustee of the firm/company has come under the adverse notice of DGFT or is in the caution list of RBI. 5. None of the Proprietor/Partners(s)/Director(s)/Karta/Trus....