Click below to download this form in pdf format:
 
 
 
 
 
APPENDIX III 
(To be filled for export goods under claim for drawback) 
Shipping Bill no. and date_____________________ 
I/We__________________________________do hereby further declare as follows:- 
1. That the quality and specification of the foods as stated in this Shipping Bill are in 
accordance with the terms of the exports contract entered into with the 
buyer/consignee in pursuance of which the goods are being exported. 
2. That we are not claiming benefit under "Engineering Products Export (Replenishment 
of Iron and Steel Intermediates) Scheme" notified vide Ministry of Commerce 
Notification No.539RE/92-97 dated 01.03.95. 
3. That there is no chance in the manufacturing formula and in the quatum per unit of 
the imported material or components, if any, utilized in the manufacture of the 
export goods and that the materials or components which have been stated in the 
application under Rule 6 or Rule 7 to have been imported, continue to be so 
imported and are not been obtained from indigenous sources. 
4. A. That the export goods have not been manufactured by availing the procedure 
under rule 191A/191B or under Rule 12(1)(b)/13(1)(b) of the Central Excise 
rules,1944. 
OR 
B.That the export goods have been manufactured by availing the procedure under 
rule 191A/191B or under Rule 12(1)(b)/13(1)(b) of the Central Excise rules,1944. 
5. A. That the goods are not manufactured and/or exported in discharge of export 
obligation against an Advance Licence issued under the Duty Exemption Scheme 
(DEEC) vide relevant Import and Export Policy in force. 
OR 
B. That goods are not manufactured and are being exported in discharge of export 
obligation under the Duty Exemption Scheme (DEEC),but I/We are claiming 
drawback of only the Central Excise Portion of the duties on inputs specified in the 
Drawback Schedule except for the Central Excise Portion of duties on inputs 
permitted import free of Addl. Duty of customs against Advance Licence. 
6. That the goods are not manufactured and/or exported after availing of the facility 
under the Passbook Scheme as contained in para 54 of the Export and Import Policy 
(April. 1992 -31st March, 1997).
7. That the goods are not manufactured and/or exported by a unit licensed as 100% 
Export Oriented Unit in terms of Import and Export Policy in force. 
8. That the goods are not manufactured and/or exported by a unit situated in any Free 
Trade Zone/Export Processing Zone or any such Zone. 
9. That the goods are not manufactured partly or wholly in bond under Section 65 of 
the Customs Act, 1962. 
10. That the present Market Value of goods is as follows:- S.No ITEM NO. INVOICE MARKET VALUE 
_____________________________________ 
___________________________________ 
11. That the export value of the goods covered by this Shipping Bill is not less than the 
total value of all imported materials used in manufacture of such goods. 
12. That the market price of the goods being exported is not less than the drawback 
amount being claimed. 
13. That the drawback amount claimed is more that 1% of the FOB value of the export 
product or the drawback amount claimed is less than 1% of the FOB value but more 
than Rs.500.00 against the Shipping Bill. 
14. I/We undertake to repatriate export proceeds within 6 months from date of export 
and submit B.R.C to Asstt. Commissioner (Drawback). In case, the export proceeds 
are not realized within 6 months from the date of export, I/We will either furnish 
extension of time from R.B.I and submit B.R.C within such extended period or will 
pay back the drawback received against this shipping bill. 
Date___________ 
For (Name of Company) 
NAME AND SIGNATURE OF THE EXPORTER 
(* Strike out whichever is not applicable)
 
The above information is a part of Import Export Training course online
 
Related posts about Export Import  Online Training ;
What is the difference between re-exports and re-imports 
How does First Appraisement system of import customs clearance procedures work? 
How does Letter of Credit work? 
 Rummaging 
Importance of Bill of Lading  
Introduction to this web site 
 Post shipment finance in Export Business 
PRECAUTIONS TO BE TAKEN WHILE USING CONTAINERS FOR EXPORTS
 Printing machine error with customs – Un able to hand over documents to carrier.
Procedure and Documentation for Filing Claim of Marine Insurance. 
 What is VACIS exam in US import customs clearance 
Procedures and documentation on Triangular shipments 
 Procedures for Re-importsWhat is the difference between re-exports and re-imports 
How does First Appraisement system of import customs clearance procedures work? 
How does Letter of Credit work? 
 Rummaging 
Importance of Bill of Lading  
Introduction to this web site 
 Post shipment finance in Export Business 
PRECAUTIONS TO BE TAKEN WHILE USING CONTAINERS FOR EXPORTS