APPLICATION FORM FOR APPROVAL FOR EXPORT OF SCOMET ITEMS FROM STOCKIST ENTITY TO END USER

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....tion of export item/ including technical specification ITC (HS) Code No.(if available) Quantity Total FOB Value In relevant foreign currency In Rupees In US$ 3. Details of exports of stocked items made previously Sl.No. Approval no. & Date Details of items to be exported Quantity exported Country which the item is to be exported DGFT's HQ File number Category Description 4. Shipment Details: i. Port of Loading/Shipment ii. Port to Discharge iii. Country to which item to be exported iv. Ultimate Destination Country 5. Purpose of Export (please tick and give clarification if any): i. Trade ii. Sample iii. Display/Exhibition 6A. Foreign Buyer Details: I. Name ii. Address Flat/Plot/BlockNo. Street/Area/Locali ....

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....mount in Rupees, Demand draft No./Electronic Fund Transfer no. and Date and the name & branch of the bank on which drawn 9B. Jurisdictional Regional Authority of original 'Stock & Sale' authorization: DECLARATION/UNDERTAKING 1. I/We hereby certify that: (i) I/We hereby declare that the particulars and the statements made in this application are true and correct to the best of my I/our knowledge and belief and nothing has been concealed or held there from. (ii) I/We fully understand that any information furnished in the application if found incorrect or false will render me liable for any penal action or other consequence as maybe prescribed in law or otherwise warranted. (iii) I/We undertake to abide by the provisions of the ....