APPENDIX 22 BANK CERTIFICATE OF EXPORT AND REALISATION FORM NO.

1
Note : Please see chapter 4 and 5 of the policy and chapter 4 and 5 of Hand book
To: Jt Director General of Foreign Trade, 11th Floor, Govt.M.S.Builiding,Laldarwaja,Ahmedabad (Name and address of Regional Authority)

We,AXIS SOLUTIONS PVT LTD,PLOT No.324.ROAD No.5,G.I.D.C.KATHWADA,AHMEDABAD-382 430 (Name and address of the expoter) hearby declare that we have
forwarded a documentary export Bill to Axis Bank Ltd, Trishul,opp.samarheswar Temple,Law Garden.Ellisbridge.Ahmedabad-380 009

Export Promotion
Copy of Shipping Dascription of goods
Bill duty as given in the custom Bill of Lading/ Dascription Bill amount
Invoice Authenticated by authenticated shipping Bill PP Receipt / AirwayBill of goods CIF/C&F/FOB
customs (in foreign --
No Date No. Date No. Date Country Name exchange)
1 2 3 4 5 6 7 8 9
EXP/2008-09/01 6/9/2008 1101408 11/9/2008 Analyser sampling system (43x58x81)
Co2 Sampling system in cabinet AWB NO.12533410602 12/9/2008 United Kingdom 2060449.85
(35x30x24)Packed Net.595KG
03 Wooden box

Freight amount Insurance amount Commission/ Whether the export FOB value/FOB value Date of Realisation GRI/PP/ No.Date &
as per Bill of as per insurance Doscunt paid/ is in freely convertible actually realised of export proceeds SDF Category
Lading/freight company's payable currency or in Indian in free Foreign Form No. of applicable
memo Bill/ Receipt Rupees Exchange/Rupee authorisation
10 11 12 13 14 15 16 17

GBP.25950.25 NIL NIL GBP GBP 25950.25 6/9/2008 SDF of Advance

Rs.2060449.85 dated.06/09/2008 Authorisation

We further declare that the aforesaid particulars are correct. (copies of invoice relevant to these export and customs attested E.P.Copy of relvant Shipping Bill is attached for verification by bank.

Place: Ahmedabad Full Official Address : AXIS SOLUTIONS PVT LTD,PLOT No.324.ROAD No.5,G.I.D.C.KATHWADA,AHMEDABAD-382 430 Signature of the Exporter
Date:
Full Res. Address : 34 Shantinagar Socity,Juna vadaj Ahmedabad.380 013 Name in Block Letters: BIJAL.SANGHVI
Designation : DIRECTOR

Office Seal/Stamp
 BANK's CERTIFICATE
Authorised Foreign Exchange Dealer Code No.alloted to the Bank by RBI: 63600035700009
AXIS Bank Ltd,Trisul,Opp.Samartheswar Temple,Law Garden, Ref No. :
Ellisbridge,Ahmedabad-380 009. Date :
Place :

1. This is to certify that we have verified the relevent export Invoice,custom attested E.P.Copy of the Shipping bill and other relevant document of
M/s. AXIS SOLUTIONS PVT LTD,PLOT No.324.ROAD No.5,G.I.D.C.KATHWADA,AHMEDABAD-382 430.
We further certify that the particulars given in Col.1to 17 have been verified and found to be correct.We have also verified the F.O.B value mentioned in col.14
above with reference to following documents:-

(i.) Bill of ladind/PP receipt/ Airways Bill AWB 125334

: 10602
(ii). Insurance Policy/Cover/Insurance Receipt

2. FOB actually realized and date of realization of export proceeds are to be given in all cases except where consignment has been sent against confirmed irrevocable
letter of credit or export made against the Government of india/Exim Bank Line of exports made under Deferred Payment / Suppliers line of credit contract backed by
by ECGS Cover.An endorsemant to that effect need to be endorsed in BRC.

3. We have also verified that the date of export is AWB 12533410602 Date: 12/9/08

4.This is to certify that we have certified the amount of the commission paid/ payable, as declared above,by the expoter I.e.Rs.-------------N/A---------------------

________________________________________
(Signature of the Bankers)

Full Address of the Banker AXIS BANK LIMITED

TRISHUL.OPP.SOMARTHSHWAR TEMPLE
Brannch and City LAW GARDEN,AHMEDABAD-6
Official Samp