Free Application for Export Licence for Restricted Items Form - PDF Form Download
Download and use this form for applying for an application to export Restricted Items. The Authorization and approval of the Export should take place before you try to export these goods. This form is only applicable in India.
Text version of this Form
3. Application Submission Details (in case of electronically submitted applications)
i. ECOM Reference Number
ii. Date of Submission on Server
iii. Submitted to which Regional Authority
iv. File Number
v. Date of Issue
5. Total FOB value applied for
i. In Rupees
ii. In Foreign Currency
6. Details of items applied for export
S No Description ITC(HS) Code Quantity FOB Value (Rs)
7. Details of exports made of the item applied for in the preceding 3 licensing years
Year Export Licence Details Quantity
FOB Value of
Exports (US $)
No. Date Qty Value
8. Purpose of Export (please tick)
( v )
9. Foreign Buyer Details
iii. Export Order no and date
11. Shipment Details
i. Port of Loading
ii. Port of Discharge
iii. Country of Export
12. In case of export of samples / exhibits / gifts, please furnish
i. Ceiling Limit
ii. How much in excess of Ceiling Limit
iii. Justification for Excess
13. In case of export by Post, please furnish details of Postal authorities where the parcel will be placed
14. In case of export of Seeds, please furnish
i. Details of seed/planting material proposed for export
ii. Whether seed/planting material proposed to be exported is of notified variety: Yes/ No
iii. Whether seed/planting material proposed to be exported has been produced under custom production arrangement? If
yes, enclose details /agreement entered into with buyer
iv. Whether variety of seed/planting material proposed to be exported is used in India: Yes/No
v. Places where the variety proposed to be exported is grown
15. Any other relevant information
I / We hereby declare that the particulars and the statements made in this application are true and correct to the
best of my / our knowledge and belief and nothing has been concealed or held there from.
I / We fully understand that any information furnished in the application if found incorrect or false will render me
/ us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted.
I / We undertake to abide by the provisions of the FT (D & R) Act, 1992, the Rules and Orders framed there
under, FTP, HBP v 1 and HBP v2 and ITC (HS).
I / We hereby certify that the firm / company for whom the application has been made has not been penalized
under Customs Act, Excise Act, FT (D & R) Act 1992 and FERA / FEMA.
I / We hereby certify that none of the Proprietor / Partner(s) / Director(s) / Karta / Trustee of firm / company, as
the case may be, is / are a Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / Company
which has come to adverse notice of DGFT.
I / We hereby certify that the Proprietor / Partner(s) / Director(s) / Karta / Trustee, as the case may be, of the
firm/company is / are not associated as Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm /
company which is in the caution list of RBI.
I / We hereby certify that neither the Registered Office / Head Office of the firm/company nor any of its Branch
Office(s) / Unit(s) / Division(s) has been declared a defaulter and has otherwise been made ineligible for
undertaking import / export under any of the provisions of the Policy.
I / We hereby declare that I / We have not obtained nor applied for such benefits (including issuance of an
Importer Exporter Code Number) in the name of our Registered / Head Office or any of our Branch(s) / Unit(s) /
Division(s) to any other Regional Authority.
I / We hereby declare that I/we have perused the list of SCOMET items as contained in the Appendix 3 to the
Schedule 2 of the ITC (HS) and that the item(s) exported / proposed to be exported does not fall within this list
and that I / We agree to abide by the provisions of FTP for export of SCOMET items contained in the FTP,
Schedule 2 of ITC (HS) and the HBP v1, irrespective of the scheme under which the item is exported /
proposed to be exported.
I / We solemnly declare that I / We have applied for / obtained a RCMC to the EPC which pertains to our main
line of business. In case we have applied to any other council, the application has been made within the
purview of the provisions of Para 2.67 and Para 2.67.1 of the HBP v1.
I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the Policy.
Signature of the Applicant Place
GUIDELINES FOR APPLICANTS
Please see paragraph 2.50 of HBP v1
Two copies of the application must be submitted unless otherwise mentioned.
Each individual page of the application has to be signed by the applicant.
a. ANF 1 has to be filled in by all applicants. In case of applications submitted electronically, no hard copies of
ANF1. However in cases where applications are submitted otherwise, hard copy of ANF1 has to be submitted.
Only relevant portions of Application need to be filled in.
Application must be accompanied by documents as per details given below:
For Export Licence for Restricted Items