I/We hereby confirm that I/We have examined the prescribed registers and also the relevant records of M/s..........................having IEC number... and P! number.for the licensing period"s# and hereby certify that$ "i# %he follo&ing documents/ records have been furnished by the applicant firm/company and have been examined and verified by me/us namely$ ' a. (tatutory documentation under the Customs ct )*+, and Excise ct )-.-/ (ervice %ax ct/ 0oreign %rade "1evelopment 2 3egulation# ct )**,4 b. Export 5rder/Contract/ (hipping 6ills/ 6ill of 7ading "and/or ir&ays 6ills/PP 3eceipts#/ Customs/6an8 attested Invoices/ 6an8 Certificates of exports made in their o&n name/ 93 declaration etc and connected boo8s of accounts4 c. 6an8 Certificate of direct foreign exchange earning/ 93 declaration/ 0or&ard In&ard 3emittance Certificates "0I3Cs#/ Certificate from international credit card companies/ C. certificate for the indirect sources/ certified statements from the 6an8er/ Chartered ccountant of 0oreign Exchange Earnings and connected boo8s of accounts. "In respect of indirect forex earnings duly certified by Chartered ccountant such as amount received from %ravel agents/%our 5perators/ 0oreign irlines for stay of Cre& and Catering/ :! organi;ations and 1iplomatic Missions and Encashment Certificate from authori;ed dealers and others in terms of 190% Policy circular no.+</*=',<<, dated ,..),.)**-# "ii# %he relevant accounting and financial register"s# as prescribed under different cts and 3ules made there under have been maintained and authenticated under my/our seal and signature. "iii# %he information given by the applicant firm/company in the >ayaat !iryaat 0orm? including details on a. imports/exports made and services rendered/ b. foreign exchange earnings/ reali;ation "both from direct and indirect sources# c. third party exports d. deemed exports is in agreement &ith the 0oreign %rade Policy ,<<.'<* and the rules and procedures made there under/ the relevant register and records and the boo8s of accounts maintained by M/s........... ... and their subsidiaries and is also true and correct. "iv# It has been ensured that the information furnished is true and correct in all respects4 no part of it is false or misleading and no relevant information has been concealed or &ithheld4 "v# !either I/ nor any of my/our partners is a partner/ director/ or an employee of the above'named entity/ its 9roup companies or its associated concerns4 "vi# I/We further certify that M/s................... has realised 95% or more of the export proceeds in respect of exports made by him in the preceding three licensing years [excluding the export made during last six months from the date of filing of application and 9!% in the case of exports made in the current licensing year on the basis of "hich recognition is being claimed. #applicable for obtaining status certificate afresh$ I/We further certify that M/s................... has realised 95% or more of the export proceeds in respect of exports made by him in the preceding three licensing years [excluding the export made during last %&! days from the date of filing of application and 9!% in the case of exports made in the current licensing year on the basis of "hich recognition is being claimed. #applicable for rene"al of status$ I/We hereby certify that the total 'alue of outstanding export proceeds beyond a period of %&! days from the date of exports made by the applicant is (s.)))))))))))))) #applicable in case of existing status holders for rene"al of status and for *+,- redemption$. I/We hereby certify that the total 'alue of outstanding export proceeds beyond a period of & months from the date of exports made by the applicant is (s.)))))))))))))) #applicable for obtaining status certificate afresh and for *+,- redemption$. "vii# I/We fully understand that any statement made in this certificate/ if proved incorrect or false/ &ill render me/us liable to face any penal action or other conse@uences as may be prescribed in la& or other&ise &arranted. "viii# I/We verify that in case the status of (tar Export Aouse is being claimed under the double &eightage export performance criteria/ the exports have been made by B "a#:nits in (mall (cale Industry/ "b# %iny (ector/ "c#Cottage (ector or "d#:nits registered &ith CDICs or "e#CDI6s or "f#:nits located in !orth Eastern (tates/ "g# (i88im and "h#E2C or :nits exporting "i# handloom/ "F# handicrafts/ "8# hand 8notted carpets/ "l#sil8 carpets or "m#exporters holding golden status or "n#exporters exporting to countries in 7atin merica and "o# CI(/ "p#sub (aharan frica or "@#:nits having I(5 *<<< "series#/WA59MP/ACCP/(EI CMM level'II and above status granted by agencies listed in ppendix',- or "r#service exporters or "s# agri exporters "other than grains#. a# "B (tri8e out &hichever are not applicable# Export 5rder/ Invoice b# 6an8 Certificate of foreign exchange earning/0I3Cs and 93 declaration (l.!o. Gear 056 Dalue of Exports
"(ignature and (tamp/ (eal of the (ignatory#
"Chartered ccountant/ Cost 2 Wor8s ccountant#
!ame of the (ignatory$ Place$ ddress$ 1ate$ Membership !o$ If any of the documents of record mentioned in serial number "i# have not been maintained/ furnished/ examined or verified/ they may please be specified belo&$' ).
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Annexure to the Cert!"#te o! Ch#rtere$ A""ount#nt/ Co%t #n$ Wor&% A""ount#nt (.!o (hipping 6ills !os 1ate of 7et Export 1escription of product 056 value "in rupees#
Note' .. Each page of this annexure is to be signed by the Chartered ccountant &ith his registration number. /. %he annexure shall be re@uired to be furnished only &ith the application for grant of 5ne to 0ive (tar Export Aouse.