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["APPENDIX-III"]
["DRAWBACK/DEEC DECLARATION"]
["(To be filed for export goods under claim for Drawback)"]
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["Shipping Bill No :                                       Date:"]
[]
["I/We  _____________________________________________  (Name of the Exporter) do hereby declare as follow:"]
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[1,"That the quality and specification of the goods as stated in this shipping bill are in accordance with the term of the exports Contract entered into with the buyer / consignee in pursuance of the goods which are being exported."]
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[2,"That there is no change in the manufacturing formula and in the quantum per unit of the imported material or Components , if any,utilized in the manufacture of the export goods and that the materials or components which have been  stated in the application under Rule 6 or Rule 7  , to have been imported, continue to be so imported andhave  not been obtained from indigenous sources."]
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[3,"* (A) That the export goods have not been manufactured by availing the rebate of duty paid on materials used in the manufacture or processing of such goods under Rule 18.The goods have not been manufactured in terms of Rule 19(2)of the Central Excise Rule,2002."]
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[null,"* (B)  That the export goods have been manufactured by availing the rebate of duly paid on materials used in the manufacture of processing of such goods under Rule 18.The goods have been manufactured in terms of Rule 19(2)of the  Central Excise rule,2002. but we are not claiming DBK on the basic of All industry rate .we are/ shall be claiming drawback on the basis of special brand rate in terms of Rule 6 of the Customs and Central Excise Duties Drawback Rules,1995."]
[null,"(* Strike out whichever is not applicable )."]
[]
[4,"*(A)  That the goods are not manufactured of exported in discharge of export obligation against an Advance licence issued  under the Duty exemption scheme (DEEC) in terms of the relevant import and export policy in foreign Trade Policy as the case may be."]
[null,"OR"]
[null,"*(B)   That goods are manufactured and are being exported in discharge of export obligation under the duty exemption scheme (DEEC), in terms of Notification No. 31/97-Cus  dated 01.04.1997 or against Duty Free Replenushment Certficate License in terms of notification no:48/2002 cus dated  25.4.2000 or against Duty Free Replenishment Certificate license,in terms of notification no.46/2002-cus.dated 22.4.2002 or against Duty Free Replenishment Certificate License  issued in terms of notification no.90/2004. Customs.dated 10.9.2004 but I /We are claiming only the Central Excise portion of duty drawback i the drawback table."]
[null,"OR"]
[null,"*(C)   That goods are manufactured and are being exported in discharge of export obligation under the duly exemption scheme(DEEC)  but I/we are claiming brand of Drawback fixed under Rule 6 & 7  the Customs & Excise Duties of the DBK Rules 1995."]
[null,"(* Strike out whichever is not applicable )."]
[]
[5,"That the goods are not manufactured  or exported after availing of the facility under the DEPB Scheme as contained in para  7.14  read with para 7.17 of the Export and Import Policy ( April 1997 - 31st March,2002) or as contained in para 4.3 of the Export and Import Policy ( April,2002- 31st March,2007) , read with para 4.37 of the Hand Book of Procedures (Vol. I ) issued under the provisions of the said policy or manufactured or exported availing of the facility under the Duty Entitlement Pass Book Scheme as contained in paragraph 4.3, of the Foreign Trade Policy 2004-2009, read with paragraph 4.37 of the Handbook of Procedures ( Volume 1 ) issued under provisions of the said policy."]
[]
[6,"That the goods are not manufactured and /  or exported by a unit licensed  as 100 % Export oriented unit in terms of import and Export Policy or Foreign Trade Policy as the case may be."]
[]
[7,"That the goods are not manufactured and / or Exported by a unit situated in any Free Trade Zone or  Export Processing Zone or Special Economic Zone."]
[]
[8,"*(a) That the goods are not manufactured partly or wholly in bond under section 65 of the Custom Act, 1962."]
[null,"OR"]
[null,"*(b)That the goods are manufactured partly or wholly in bond under section 65 of the Customs Act 1962."]
[null,"(* Strike out whichever is not applicable)"]
[]
[9,"That Present Market Value of the goods is as follow:"]
[null,"Sr. No",null,"Item No in Invoice",{"$nulls":6},"Market Value"]
{"$rows_empty":10}
[10,"That the export Value of the goods covered by this shipping bill is not less than the total value of all imported materials"]
[]
[11,"That the market price of the goods being  exported is not less than the drawback amount being claimed."]
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[12,"That the Drawback amount claimed is more that 1 % of the FOB value of the export product: or the Drawback amount Claimed is less than 1% of the FOB value but more than Rs. 500.00 against the Shipping Bill."]
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[13,"I /We undertake to repatriate export proceeds within 6 months from date of export and submit  The necessary Bank Realisation Certificate to this effect to Deputy Commissioner (Drawback). In case,the export proceeds are not realized 6 months from the date of export. I/We will either furnish evidance as to the extension of time limit in this regard granted by the Reserve Bank of India and submit relevant Bank Realisation Certificate within suvh extended period or will pay back the drawback received against the exports effected under the cover of this Shipping Bill."]
[]
[14,"That the duties of Customs and Central Excise have been paid respect of the containers, packing materials and materials unused in the manufacture of the export goods on which drawback is being claimed and in respect of such containers of materials no separate claim for rebate of duty under Rule 18 of the Central Excise Rules,2002 has been made or will be made to the Central Excise Authorities."]
[]
[]
[]
[null,"Date : "]
[null,"Name of Exporter :"]
[null,"Address :",{"$nulls":6},"(Stamp & Signature of the Exporter)"]