A.   Documents needed


1. Bank receipt/Demand Draft/EFT details for application fee           :Yes/No


2. Original/self certified photo copy of E.P. copy of Shipping Bill/  

    Bill of export                                                                                   : Yes/No


3. In case of photo copy; following needed :


(a)   Reference No. of licence file in which the original E.P.

         copy  has been  submitted to be mentioned on the photo

         copy                                                                                            : Yes/No


(b) Original DEPB/DEEC/Drawback copy needed                        : Yes/No


4. BRC in form 22A marked as original consolidated for all

    Shipping Bills of each bank only for eligible exports                                                                  

                                                                                                            : Yes/No


5. Self certified copy of Customs invoice in case of manual Shipping

    Billand commercial invoice in case of EDI Shipping Bill                : Yes/No         


6. Self certified copy of the Balance Sheet filed with the Income Tax

   Authority for the 2002-03 and 2003-04.                                         : Yes/No


7. In case of 3rd party export, following needed :


   (i) Copy of Export order                                                                  : Yes/No

   (ii) Copy of G.R. form                                                                     : Yes/No


8. Copy of Status Certificate valid  during 2003-04                          : Yes/No


9.Copy of RCMC  valid during 2003-04                                          : Yes/No


10. Copy of RCMC currently valid                                                     : Yes/No


11. CA/ICWA/CS Certificate as per Annexure to Appendix 17-D    : Yes/No


12. Undertaking that VKUY certificate has not been and will           : Yes/No

      not be applied for


13.  CA/ICWA/CS Certificate of Annual export turn over during

2002-03 and 2003-04 either at end of row 1 of  Sl.6 of form

17D or sepqarate certificate                                                       : Yes/No


14.     Certificate for signatory to be authorised signatory of the

firm in case of limited companies & partnership firm                : Yes/No

































B.Analysis Sheet


1. Name of exporter                                                                            :


2. Whether Status Certificate valid for 2003-04 checked

    with register                                                                                    :  Yes/No


3. (a)Whether claim for group company?                                         : Yes/No


    (b) If yes, whether individual companies growth > 25%                : Yes/No


    ( c ) Group growth>25%?                                                               : Yes/No


4. Any licence fee shortfall [No concession allowed]                     : Yes/No


5. Whether all S/B checked on intranet  ?                                           : Yes/No


6. (a) Whether all ineligible export removed?                                    : Yes/No


(b)Any re-export of imported goods or export made through

Transshipment ? If yes. Whether S/B FOB removed from

export ?                                                                                      : Yes/No


(a)   Any export by EOU/SEZ/EHTP/STPI or manufactured by

them included? If yes, whether S/B FOB removed from

export ?                                                                                 : Yes/No


  (d) Deemed export removed from export figure ?                            : Yes/No


  (e) Service export removed from export figure?                              : Yes/No


  (f) Whether supply by one Status holder to another removed ?        : Yes/No


(g) Whether export of one Status holder on behalf of another

     removed                                                                                       : Yes/No


(h) Supply made by non-status holder to status holder removed

     if both less have less than 25% incremental growth ?                : Yes/No


(i)    Export made by group and individual companies less than

25%  of incremental growth removed?                                       : Yes/No                                                                                            


(j) All transfer of export from other than exporters removed ?          : Yes/No


(k)  Whether export of rough, uncut/semi polished diamonds

removed from eligible exports?                                                : Yes/No


(l)    Whether export of gold, silver in any form and plain jewellary

removed from eligible export?                                                  : Yes/No


(m)Whether export of foodgrain sourced from FCI removed from

    eligible export?                                                                         : Yes/No


(n)Whether free shipping bill export removed from eligible export?: Yes/No



7. (a) Eligible export 2002-03              -US$-                                  :


   (b) Eligible export 2003-04               -US$-                                  :


  (c) Whether eligible export during 2003-04 > 25 crores                 : Yes/No


  (d) Whether % of growth positive[04 over 03]                             :Yes/No


  (e) Incremental eligible export o4 over 03>25%                            : Yes/No



8. Duty Free Credit Entitlement as realised export during 03-04 in  :

    Rs. as per calculation in row 10 of para 6 of form 17D


8. If split up needed :


    (a)Denominations                                                                          :


    (b) Licence fee correct?                                                             : Yes/No


9. (a) Whether entitlement for supporting manufacturer opted          : Yes/No


(b)If yes, % of eligible export 03-04 done by supporting             :



   (c) Entitlement for supporting manufacturer in Rs.               :


10. Whether export turn over of 02-03 & 03-04 tallies          

     approximately with the balance sheet submitted with

     Income Tax department ?                                                  : Yes/No


11.Whether eligible export product groupwise declared is       : Yes/No

    correct as per S/B and invoice in row 12 of Sl.6 of form



12. Whether eligible export product groupwise declared for

      supporting manufacturer is correct as per S/B & invoice       : Yes/No


13. % of  Realised export of 03-04 is approximately maching

    with BRC in row 8 of sl.6 of Form 17-D [Realised export

    as per let export date]                                                            :Yes/No


14. Whether export order, Invoice, G.R. form, BRC in the name

       of applicant in the case of 3rd party export                                 : Yes/No


15. All S/B have been finally assessed?                                           : Yes/No


15.     Whether export of Food product Group (agriculture, dairy,

minor, forest produce items etc.)? If yes,   confirmation            :Yes/No        confirmation has been done ehtat no VKUY cerficate not



Note :


1.     After issue of certificate make on DEPB/DEEC/Drawback copy of S/B that DFCE of status holder issued


2.     In case of Capital Goods/office equipment, a Certificate from Central  

Excise/independent Chartered Accountant needed confirming installation of the goods within 6 months of import.