APPENDIX 11A
DATA SHEET FOR ADVANCE LICENCE
APPLICATION
ON SELF DECLARATION UNDER PARA 4.4.2
& 4.7 OF HANDBOOK (Vol.I)
1. Details
of Items required for manufacture of one Unit of Export Product:
(a) Imported inputs:
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S. No. |
Required
import item |
Quantity required per unit of resultant product |
Purpose
of requirement * |
Wastage claimed (%age) on net content basis. |
Recoverable
wastage/by product |
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Description |
Technical
Character-istics |
ITC(HS)
Code |
Name |
Quantity |
value |
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* |
Purpose of requirement should be
indicated against each item whether the same is required as raw material,
components, consumables solvents, catalysts, packing material etc. |
(b) Indigenous inputs
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S. No. |
Required
import item |
Quantity required per unit of resultant product |
Purpose
of requirement * |
Wastage claimed (%age) on net content basis. |
Recoverable
wastage/ by
product |
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Description |
Technical
Character-istics |
ITC(HS) Code |
Name |
Quant-ity |
value |
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1. Production
and consumption data of the manufacturer/supporting manufacturer (of preceding
three licensing years duly certified by the Chartered Accountant/Cost and Works
Accountant/Jurisdictional Central Excise Authority*):
*In case
there is no past production, the Jurisdictional Central Excise Authority shall
certify the production and consumption data on the basis of production batch
sheets and for this purpose the firm shall maintain separate record of batch
data for inputs consumed in the manufacture of the export product.
|
Year |
Total production of the resultant product |
Quantity of different Items consumed |
Quantity consumed/unit production |
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(1) |
(2) |
(3) |
(4) |
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3. |
Particulars of the licences
obtained in the past and ratified by ALC (with or without modification) for the
same export product covered under this application. |
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S.No. |
Licence No & Date |
Description of export product |
Description of import items |
Import item qty per unit of export product (as
applied for) |
Import item qty per unit of export product (as
approved by ALC while ratifying licence) |
ALC meeting No & Date when approved |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
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Please furnish technical details
as per Annexure-I of Appendix-10 depending upon the resultant product. Please
confirm. |
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5. |
a) FOB value of exports in the preceding licensing
years |
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b) CIF value of licences already obtained under
paragraph 4.7: |
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c) Balance entitlement as per paragraph 4.71. |
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CHARTERED
ENGINEER CERTIFICATE
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I have examined the applicant
company's import requirements of raw materials, components etc with regard to
their technical description/ specification and the quantity against each item
of import and having regard to proper technical norms of consumption and
after technical scrutiny of relevant designs and drawings, I hereby certify
that they are correct in all respects and are actually required for the
execution of the export/supply contracts for
......................... The list of Items covers
_________ pages and contains __________ items for a total value of
Rs._____________ (in free foreign exchange __________ ) |
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Signature..................................
Name in Block
letters................
Designation...............................
Address....................................
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Place: ............. |
Name and
Address of the Institution under which Chartered |
: .................................. |
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Date: .............. |
Ref No.
and date of Corporate Membership |
: .................................. |