To be submitted in duplicate

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....No. Name and address                     Declarations Yes/No as applicable 1 We declare that we intend to claim rewards under export promotion Scheme (a) Drawback (b) Any other Scheme         2 We declare that we intend to zero rate our exports under sectio....

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....ters) Number Gross Net 1 2 3 4 5 6 7 8   10 11 12 13 14   Details of Tax invoice or commercial invoice (whichever applicable) Details of duty/ tax H.S code Invoice details value Customs duties GST details Total invoice no. and date Sl. No. of item in invoice Export duty Cess IGST (if applicabl....