1 Name and address of the Exporter. 2 Coffee Board Registration Number and date/valid up to 3 Importer/Notify Party Address

Transcription

1 (Annexure-2) COFFEE BOARD: BANGALORE (Revised on 1 st October 2002) COMPOSITE APPLICATION FORM FOR ISSUE OF EXPORT PERMIT FOR RE-EXPORT OF IMPORTED COFFEE. (TO BE SUBMITTED IN DUPLICATE) 1 Name and address of the Exporter 2 Board Registration Number and date/valid up to 3 Importer/Notify Party Address 4 Type and Grade of to exported 5 Crop Season 6 Quantity in kilos for which export permit is required 7 GBE in kilos. Actual quantity utilized to prepare RS/R&G/IC 8 F.O.B. Value a) in US$: 9 Port of Shipment 10 Port of Destination 11 Country of Destination 12 Name and address of Forwarding Agent b) in Rupee: 13 Parcel/Mark Number 14 State Code RS Roasted Seeds R & G Roasted and Ground IC- Instant GBE Green Bean Equivalent (Raw ) 2

2 DETAILS OF IMPORT/EXPORT: -2- PARTICULARS Raw/Green R & G/ RS Instant Other types Pl. Specify a) Opening balance of Imported as on 1 ST Jan. b) Imports from 1 ST Jan. Till date of application *** c) Quantity Imported ( a + b ) d) Qty Exported from 1 ST Jan.till date of application e) Balance left ( c-d ) f) Export Permit now applied for g) Balance left ( e- f ) Sl. No. Certificate of Origin Bill of Entry No. Date No. Date Name of Port Country from which coffee is Type of coffee Imported viz., Arabica/ Robusta/ Instant/RS/ R&G Qty Imported In Kgs. in which is Value in Equivalent value in Rupees The total should tally with the total given in the imports from 1 ST Jan... till date of application on page No.1 and Sl. No. 14(b). Please enclose Xerox copy of the Certificate of Origin in support of above imports made. DECLARATION 1. Certified that the above application is made to obtain export permit for exporting of coffee in processed form by roasting or conversion into soluble coffee as value added coffee only. 2. I / We hereby declare that the guidelines issued by the Board, Bangalore on export of coffee vide Circular number Exports/2001/1838 dated 11/01/2001 is strictly adhered to. 3. Certified that the green coffee is not re-exported in the form of raw/green coffee or re-exported as mixed with green coffee. 4. I / We hereby declare that we have entered into a firm contract with foreign buyer(s) for export of coffee as furnished in Export Permit Application above. Further declare to adhere to the code of fair business practice and the terms and conditions of contract in case of failure of above, shall abide to the proceedings of Board in this regard. 5. I / We also declare that information furnished above is true and correct to the best of our knowledge. If found false, My/ our Export Registration is liable for cancellation along with export permit and other related documents by the Board without any prejudice. Signature & Seal of the Exporter/ Place: Authorized Signatory Date: On behalf of the Registered Exporter To: THE CHIEF COFFEE MARKETING OFFICER, COFFEE BOARD, BANGALORE.

3 (Annexure-2) COFFEE BOARD: BANGALORE (Revised during November 2013) COMPOSITE APPLICATION FORM FOR ISSUE OF EXPORT PERMIT FOR RE-EXPORT OF IMPORTED COFFEE. (TO BE SUBMITTED IN DUPLICATE) 1 Name and address of the Exporter 2 Board Registration Number and date/valid up to 3 Importer/Notify Party Address 4 Type and Grade of to be exported 5 Crop Season 6 Quantity in Kilos and its FOB value for which export permit is required: 1. Qty: 2.FOB Value in INR: 3. the : 4.FOB Value in : In the case of blending Imported Instant with Instant for which Export Permit is required, please furnish the details as given below at A & B A] Qty of Imported Instant coffee in Kilos Qty of Instant In Kilos Qty In Kilos As given in column No.6 B] Import value in INR for the above said Qty at A FOB Value in INR at minimum 30% on value addition Actual FOB Value in INR As given in column No.6 8 GBE in kilos. Actual quantity utilized to prepare RS/R&G/IC 9 Port of Shipment 10 Port of Destination 11 Country of Destination 12 Name and address of Forwarding Agent 13 Parcel/Mark Number

4 14 State Code RS Roasted Seeds R & G Roasted and Ground IC- Instant GBE Green Bean Equivalent (Raw ) 2 DETAILS OF IMPORT/EXPORT: -2- PARTICULARS Raw/Green R & G/ RS Instant Other types Pl. Specify a) Opening balance of Imported as on 1 st January,. b) Imports from 1 st Jaunary,. Till date of application *** d) Quantity Imported ( a + b ) d) Qty Exported from 01/01/2007 till date of application e) Balance left ( c-d ) f) Export Permit now applied for g) Balance left ( e- f ) Sl. No. Certificate of Origin Bill of Entry No. Date No. Date Name of Port Country from which coffee is Type of coffee Imported viz., Arabica/ Robusta/ Instant/RS/ R&G Qty Imported In Kgs. in which is Value in Equivalent value in Rupees The total should tally with the total given in the imports from 01/01/ till date of application on page No.1 and Sl. No. 14(b). Please enclose Xerox copy of the Certificate of Origin in support of above imports made. DECLARATION 1. Certified that the above application is made to obtain export permit for exporting of coffee in processed form by roasting or conversion into soluble coffee as value added coffee only. 2. I / We hereby declare that the guidelines issued by the Board, Bangalore on export of coffee vide Circular number Exports/2001/1838 dated 11/01/2001 and Circular No.dated are strictly adhered to. 3. Certified that the green coffee is not re-exported in the form of raw/green coffee or re-exported as mixed with green coffee. 4. I / We hereby declare that we have entered into a firm contract with foreign buyer(s) for export of coffee as furnished in Export Permit Application above. Further declare to adhere to the code of fair business practice and the terms and conditions of contract in case of failure of above, shall abide to the proceedings of Board in this regard. 5. I / We also declare that information furnished above is true and correct to the best of our knowledge. If found false, My/ our Export Registration is liable for cancellation along with export permit and other related documents by the Board without any prejudice. Place: Date: Signature & Seal of the Exporter/ Authorized Signatory On behalf of the Registered Exporter To: THE CHIEF COFFEE MARKETING OFFICER, COFFEE BOARD, BANGALORE.

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