Free Sale Certificate

Appendix 39

APPLICATION FOR FREE SALE & COMMERCE CERTIFICATE

(i) Code No.

(ii) Name & Address of issuing authority

4.              Registration –cum-Membership Certificate (RCMC)

details

(i) Name of the Council

(ii) Registration No and date

(iii) Validity

5.         Brief Descripttion of exports                               :

(i) Details of foreign buyer with  complete address, e.mail ID etc.

(ii) Brief description of items to be exported under the certificate

6.              Whether the items of export fall under the Drugs &            :

Cosmetics Act. 1940 . If so, indicate the same.

7.              Details of items for which Free Sale & Commerce

Certificate is sought to be obtained (Annexure A to be attached duly self-certified)

8.              I hereby declare that items listed in Annexure A,

(i) are not prohibited or restricted for export under Schedule 2 of ITC (HS) and are free for export;

(ii) all the items listed in Annexure A have usage in hospitals, nursing homes and clinics, for medical and surgical purposes;

(iii) all the items listed above are not covered under Drugs & Cosmetics Act, 1940.

(Signature) Name & Designation of the Authorized Signatory Seal of the Company

DECLARATION / UNDERTAKING

1.    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.

2.        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.

3.        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).

4.      a.               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.

b.           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.

c.           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.

d.           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.

5.        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.

6.        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.

7.        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 2.63 of the HBP v1.

8.        I hereby certify that I am authorized to verify and sign this declaration as per Paragraph 9.9 of the Policy. Signature of the Applicant                                                                                                           Place

Name                                                                                                                Date                                                                         

Designation Official Address Telephone

Residential Address

Email Address

Note:

1. This form with Annexure -A may be submitted without other parts of the Aayat Niryat         Form.

2  .For  items  falling  under  the  Drug  &  Cosmetics  Act,  1940,  application  for  issue  of  Free  Sale  &   Commerce Certificate may be made to the Drug Controller General (I), Directorate General  of Health Services, Ministry  of Health & Family Welfare, FDA Bhawan, Kotla Rod,  Near Mata Sundari  Collage, ITO,  New Delhi- 110002.

Annexure - A

Proforma for Submission of list of Products

(May be clearly typed)

S. No.     Name of

Product

ITC

(HS) Code

Manufacturers/Exporters

name and address

Is    the    product    licensed

under     the      Drugs     and Cosmetics           Act                         for manufacture and sale.

Descripttion      of      the

product   including   use

(attach     literature,     if required.)

Annexure – B

Government of India

Ministry of Commerce & Industry

Department of Commerce

Directorate General of Foreign Trade

FREE SALE AND COMMERCE CERTIFICATE

The Medical Devices/Instruments as per Annexure (Total items) manufactured by M/s. (Name of the firm &

full address) are “freely permitted for sale in India as well as freely exportable”. This certificate is valid for a period of two years from the date of issue.

Encl: As above. Place:

Date:

Director General of Foreign Trade