On Company Letter Head Duly Signed by Authorised Signatory)

EIG-F-12-DTA

< On Company Letter Head duly signed by authorised signatory)

DETAILS REQUIRED FOR DTA SALES PERMISSION

(A) UNIT DETAILS

1 / Name of the Unit
2 / Location Address of the Unit
3 / STP Approval No. & Date
4 / Export Obligation Agreement date
5 / Green Card No. & Validity Date
6 / Custom Bonding No. &
Validity Date
7 / Capital Goods Limit (Rs. In Lacs)
8 / Import till date * (Rs. In Lacs)
9 / Projected Export for 5 years (Rs. In Lacs)
10 / Total Export Performance *
(Starting from the Date of approval till date) (Rs. In Lacs) /
11 / FE Outgo other than CG* (Rs. In Lacs)
12 / Net Foreign Exchange Earning * (Rs. In Lacs)
13 / Export Obligation * (Rs. In Lacs) /
14 / Period for which DTA Sales requested /
15 / DTA Eligibility
(As per Para no. 6.8 of Foreign Trade Policy 50% of last year Export) /
16 / DTA Permission issued till date
(Date of Approval and Amount) /

* Give Year wise breakup

(B) DTA SALE ORDER DETAILS
Sr. No. / Client Name & Address / Contract / Purchase Order No. & Dated /

Work Description

/ Validity of Contract /

Total Amount of Contract (Rs. In Lacs)

Total

Undertaking

I/We hereby declare that above statements are true and correct to the best of my/our knowledge and belief. I/We hereby undertake to pay all applicable duties / taxes / local levies (if any) on the DTA Sales made by us. I/We fully understand that Permission Letter granted to me /us on the basis of the statement furnished is liable to cancellation or being made ineffective, in addition to any other penalty that the Government may impose or any other action that may be taken having regard to the circumstances of the case, if it is found that any of the statements or facts therein are incorrect or false.

Place : Mumbai Signature : ______

Date : ______Name : ______

Designation : ______