ODFC FEMA Helpdesk ✳️ Lakshadweep: EXCHANGE CONTROL DECLARATION (GR) FORM NO.

Ozg FEMA Consultant

Ozg Center | London | Delhi | New York | Mumbai

Phone # 09811415831-37-61-72-84-92-94

Email: fema.consultant@ozg.co.in

Website: fema.in

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Original

Exporter

Invoice No.& Date

SB No.& Date

AR4/AR4A No.& Date

Q/Cert No.& Date

Importer-Exporter Code No.

Consignee

Export Trade Control

If export under:

Deferred Credit [ ]

Joint Ventures [ ]

Rupee Credit [ ]

Others [ ]

RBI's Approval/Cir.No. & Date

Custom House Agent L/C.No.

Pre-Carriage by

Place of Receipt

Type of shipment :

by Pre-Carrier

Outright Sale [ ]

Consignment Export [ ]

Vessel/Flight No.

Rotatio No.

Others [ ]

(Specify)

Port of Loading

Nature of Contract:CIF[ ]/C&F [ ]/FOB [ ]

Other (Specify) [ ]

Port of Discharge

Country of Destination

Exchange Rate U/S 14 of CA Currency of invoice

S.No

Marks & No. No. & Kind of Pkgs.

Statistical Code & Description of Goods

Quantity

Value FOB

Container Nos.

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency Amount

Full export value OR where not ascertainable, the

value which exporter expects to receive on the sale of goods.

FOB Value

Freight

Insurance

Currency

Commission

Rate

Discount

Amount

Other Deductions

EXCHANGE CONTROL DECLARATION (GR) FORM NO.

Is Export under L/C arrangements? Yes [ ] No [ ]	FOR CUSTOMS
If yes, name of advising bank in India	Customs Assessable value Rs.

	(Rupees .
	........................................................................................

Bank through which payment is to be received
	Export Value Verified


		Customs Appraiser

Whether Payment is to be received through the	Date of Shipment	Customs Appraiser
ACU YES/NO

Declaration under Foreign Exchange Management Act, 1999: I/We hereby declare that I/We am/are the SELLER/CONSIGNOR of the goods in respect of which this declaration is made and that the particulars given above are true and that a)the value as contracted with the buyer is the same as the full export value declared overleaf/ b) *the full export value of the goods is not ascertainable at the time of export and that the value declared is that which I/We, having regard to the prevailing market-conditions, expect to receive on the sale of goods in the overseas market.

I/We undertake that I/We will deliver to the bank named herein the foreign exchange representing the full export value of the goods on or before @ .................................. in the manner soecified in the Regulations under the Act. I/We further declare that I/We am/are resident in India and I/We have a place of business in India.

I/We* am/are OR am/are not in Caution List of the Reserve Bank of India.
......................................
Date................ (Signature of Exporter)

@ State appropriate date of delivery which must be within six months from the date of shipment, but for exports to warehouses established outside India with the permission of the Reserve Bank, the date of delivery must be within fifteen months.


* Strike out whichever is not applicable

SPACE FOR USE BY RESERVE BANK OF INDIA

EXCHANGE CONTROL DECLARATION (GR) FORM NO.

Duplicate

Exporter

Invoice No.& Date

SB No.& Date

AR4/AR4A No.& Date

Q/Cert No.& Date

Importer-Exporter Code No.

Consignee

Export Trade Control

If export under:

Deferred Credit [ ]

Joint Ventures [ ]

Rupee Credit [ ]

Others [ ]

RBI's Approval/Cir.No. & Date

Custom House Agent L/C.No.

Pre-Carriage by

Place of Receipt

Type of shipment :

By Pre-Carrier

Outright Sale [ ]

Consignment Export [ ]

Vessel/Flight No.

Rotation No.

Others [ ]

(Specify)

Port of Loading

Nature of Contract:CIF[ ]/C&F [ ]/FOB [ ]

Other (Specify) [ ]

Port of Discharge

Country of Destination

Exchange Rate U/S 14 of CA Currency of invoice

S.No

Marks & No. No. & Kind of Pkgs.

Statistical Code & Description of Goods

Quantity

Value FOB

Container Nos.

Net Weight

Gross Weight

Total FOB Value in words

Analysis of Export Value

Currency Amount

Full export value OR where not ascertainable, the

value which exporter expects to receive on the

FOB Value

sale of goods.

Freight

Insurance

Currency

Commission

Rate

Discount

Amount

Other Deductions

EXCHANGE CONTROL DECLARATION (GR) FORM NO.

Is Export under L/C arrangements? Yes [ ] No [ ]	FOR CUSTOMS
If yes, name of advising bank in India	Customs Assessable value Rs.

	(Rupees .
	........................................................................................
Bank through which payment is to be received
	Export Value Verified


		Customs Appraiser
	Cargo shipped in full/part
	Quantity
	Value
Whether Payment is to be received through the	Date of Shipment	Customs Appraiser
ACU YES/NO

Declaration under Foreign Exchange Management Act, 1999: I/We hereby declare that I/We am/are the SELLER/CONSIGNOR of the goods in respect of which this declaration is made and that the particulars given above are true and that a)the value as contracted with the buyer is the same as the full export value declared overleaf/ b) *the full export value of the goods is not ascertainable at the time of export and that the value declared is that which I/We, having regard to the prevailing market-conditions, expect to receive on the sale of goods in the overseas market.

I/We undertake that I/We will deliver to the bank named herein the foreign exchange representing the full export value of the goods on or before @ ................................... in the manner specified in the Regulation made under the Act.

I/We further declare that I/We am/are resident in India and I/We have a place of business in India.

I/We* am/are OR am/are not in Caution List of the Reserve Bank of India.
......................................
Date................ (Signature of Exporter)

@ State appropriate date of delivery which must be within six months from the date of shipment, but for exports to warehouses established outside India with the permission of the Reserve Bank, the date of delivery must be within fifteen months.

* Strike out whichever is not applicable

FOR AUTHORISED DEALER'S USE
Uniform Code Number.........................
Indicate ( ) in the box applicable Date of (I) negotiation (ii) receipt for collection. Bill No..........................
Type of Bill* (i)DA[ ]/(ii)DP [ ]/(iii)Others [ ]....................(Specify)
Type of shipment:*(i) Firm Sale Contract [ ]/(ii)Consignment Basis [ ]/
(iii)Others [ ] .......................(Specify)
The GR Form was included in the Statement sent to the Reserve Bank with
the R Return for the fortnight ending...........................sent on.......................
We certify and confirm that we have received the total amount of..............……………
(Currency) (amount)
as under being the proceeds of exports declared on this form.

Date of receipt	Currency	Credit to Nostro Account in-------------------Country		Debit to NR Rupee Account of a Bank in -------------Country			Period of R Return with which the realisation has been reported to RBI
		In our name	In the name of *--------------------------	Held with us		Held with * ---------------------
(1)	(2)	(3)	(4)	(5)		(6)	(7)



* (Write the name of the concerned Indian Authorised Dealer Branch. ) Any other manner of receipt (Specify)....................................................................................................................
					--------------------------------------- (Stamp & Signature of authorised dealer) Date:........................................ Address:....................................................... ................................................ ................................................