APPENDIX- 17

-----------------------------APPLICATION FOR GRANT OF STAR EXPORT HOUSE

---------------------------------------------------------------------------------------------------Note:
1.
2.
3.

Please see Paragraph 3.5.2 of the Policy and Paragraph 3.2 of this
Handbook.
Please read the general instruction given at Appendix 1 before filling
this application.
Please submit 2 copies of this application form.

-----------------------------------------------------------------------------FOR OFFICIAL USE

File No.:-------------------------------- Date:-----------------------------------------------------------------------------------------------------------1. Name and address
:
2. IEC Number

3. Application for Category of

S.No.

Star Export House

Category

Please tick
appropriate colum
[
]

One Star Export House

Two Star Export House

Three Star Export House

Four Star Export House

Five Star Export House

4. *Subsidiary Company:
S.No.
[1]

Company Name

% share holding of
the Applicant in
the subsidiary
[3]

[2]

FOB value of
exports
(4)

* Documentary evidence as per company law substantiating that the company

whose exports are taken into account is actually the applicants
subsidiary company.
App.19

5.

Statement of exports/ deemed exports (licensing yearwise)

Licensing years

FOB value of exports

FOR value of deemed

supplies

DECLARATION
1. I/We hereby declare that this
performance
of the
preceding
licencing year basis.

application is based on the export

three licensing years and the present

2. I/ We hereby declare that the FOB /FOR value of Exports of Products shown
above are our direct exports/ supplies and also the direct exports/
supplies of our subsidiary company and are true and correct and are in
accordance with the accounts maintained by me/ us. I/ We hereby declare
that exports made on re-export basis have not been included in the exports
indicated at S.No 5 above.
3. I/ We further certify that I/We am/are authorised to verify and sign the
statement on behalf of the applicant.
4. I/We fully
understand that any information furnished in the above
statement, if proved incorrect or false, will render me/us liable to
face any penal action or other consequences as may be prescribed in law or
otherwise warranted.
5. I/ We further declare that I/We has/have not applied nor obtained any
recognition certificate as Star Export House from any other authority.
Signature______________________
Name in Block letters _________
Designation___________________
Place___________

Full Official
Address_______________________
Official
Stamp/ Seal
Full Residential
Address_______________________

Date____________

E.Mail No.____________________

App.20

CERTIFICATE
SECRETARY

OF

CHARTERED

ACCOUNTANT/COST

AND

WORKS

ACCOUNTANT/COMPANY

I/We hereby confirm that I/We have examined the prescribed registers and also
the relevant records of M/s............................ and their subsidiary
company
namely
M/s......................
for
the
licensing
period(s) ............. and hereby certify that:
(i)

(ii)

M/s ................................ and their subsidiary company

namely M/s....................(full name and address of the applicant)
have made the exports in the current and three preceding licensing
years as specified in the statement of exports at Sl.No.7.
The following documents/ records have been furnished by the applicant
and their above mentioned subsidiary company and have been examined and
verified by me/us namely: Export Order/Contract, Shipping Bills, Bill of Lading (and/or Airways
Bills/PP Receipts), Customs/Bank attested Invoices, Bank Certificates
of exports made in their own name and connected books of accounts.

(iii)

The relevant
signature.

register

has

been

(iv)

The financial information given in the above statement is in agreement

with the relevant register and records; the same has been incorporated
in the books of accounts maintained by M/s.............and their above
mentioned subsidiaries; and is also true and correct.

(v)

It has been ensured that the information furnished is true and correct
in all respect; no part of it is false or misleading and no relevant
information has been concealed or withheld;
App.20

authenticated

under

my/our

seal/

(vi)

Neither I, nor any of my partners is a partner, director, or an

employee of the above-named entity or its associated concerns;

(vii)

I/We further certify that M/s.................... has realised 95% or

more of the export proceeds in respect of exports made by him in the
preceding three licensing years (excluding the export made during last
six months from the date of filing of application)and 50% in the case
of exports made in the current licensing year on the basis of which
recognition is being claimed.
I/We hereby certify that the total value of outstanding export proceeds
beyond a period of 6 months from the date of export made by the
applicant

(viii) I/we fully understand that any statement made in this certificate, if
proved incorrect or false, will render me/us liable to face any penal
action or other consequences as may be prescribed in law or otherwise
warranted.
(ix)

I/ We verify that in case the status of Star Export House is being

claimed under the double weightage export performance criteria, the
exports have been made by * (a)Units in Small Scale Industry/ (b) Tiny
Sector/ (c)Cottage Sector or (d)Units registered with KVICs or (e)KVIBs
or (f)Units located in North Eastern States, (g) Sikkim and (h)J&K or
Units exporting (i) handloom, (j) handicrafts, (k) hand knotted
carpets, (l) silk carpets or (m)exporters holding golden status or
(n)exporters exporting to countries in Latin America and (o) CIS/ (p)
sub
Saharan
Africa
or
(q)Units
having
ISO
9000
(series)/WHOGMP/HACCP/SEI CMM level-II and above status granted by
agencies listed in Appendix-28A or (r)service exporters or (s) agri
exporters (other than grains).
(* Strike out whichever are not applicable)
Signature.............................

Place:
..................
Registered..................
Official
Stamp/Seal

Date ...........
Regn. No.and Date of the
Corporate Membership..........

If any of the documents of record mentioned in

item (ii) of the
certificates have
not
been maintained/furnished, examined or verified,
they may please be specified below:1.
2.
3.
App.20

-----------------------------------------------------------------------------Documents to be enclosed with the application form:

-----------------------------------------------------------------------------1.

Self certified copy of valid RCMC.

2.

A certificate from Chartered

Accountant/Cost and Works Accountant
certifying the export/import performance in the prescribed format.
Bank certificate of export realization/ deemed exports for status
certificate as per Appendix 17B

3.

App.20

APPENDIX- 17-A
------------------------------APPLICATION FOR GRANT OF ONE TO FIVE STAR EXPORT HOUSE FOR SERVICE PROVIDERS
-----------------------------------------------------------------------------Note:
1. Please see Note-1 of paragraph 3.5.2 of the Policy and paragraph 3.2 of
this Handbook.
2. Please read the general instruction given at Appendix 1 before filling this
application.
3. Please submit 2 copies of this application form.
--------------------------------------------------------------------------FOR OFFICIAL USE
File No.:-------------------------------- Date:-----------------------------------------------------------------------------------------------------------1.

Name and address

2.

I E Code Number

3.

Application for
Star
Export
House
service providers

4.

for

...................................
...................................
...................................
...................................
...................................
...................................

Statement of gross foreign exchange earning direct and indirect

sources (Licensing year wise):
Licensing
year
(1)

Category of service
provider

Description
of services
provided

(2)

(3)

Gross foreign
exchange earnings
(direct and
indirect sources)
(4)

DECLARATION
1. I/We hereby declare that this application is based on the foreign exchange
earning direct and indirect of the preceding three licensing years and
current licensing year on gross foreign exchange.
2. I/ We further certify that I/ We am/ are authorised to verify and sign the
statement on behalf of the applicant.

App.20

3. I/ We fully understand that any information furnished in the above

statement, if proved incorrect or false, will render me/us liable to face
any penal action or other consequences as may be prescribed in law or
otherwise warranted.
4. I/We further declare that I/We has/have not applied nor obtained any
recognition certificate as status holder from any other authority.
Signature :.............................
Name in Block Letters :.............................
Designation :.............................
Place :.............................
Date .........

Full Official Address

:.............................

Residential Address :.............................

E.Mail address :.............................
Official
Stamp/ Seal

App.20

CERTIFICATE OF CHARTERED ACCOUNTANT/COST AND WORKS ACCOUNTANT/

COMPANY SECRETARY
I/We hereby confirm that I/We have examined the prescribed registers and also
the relevant records of M/s................. for
the
licensing
period(s) ..... and hereby certify that :
i)

M/s............................... (Full name and address of the

applicant) have earned foreign exchange earning direct and indirect
sources each of the three preceding licensing years/during the current
licensing year as specified in the statement of gross foreign exchange
earning at Sl.No.5.

ii)

The following documents/records have been furnished by the applicant and

their above mentioned subsidiary company and have been examined and
verified by me/us namely: Bank Certificate of direct foreign exchange
earning, FIRCs, certificate from international credit card companies
etc. and C.A certificate for the indirect sources.

iii) The
relevant
seal/signature.

register

has

been

authenticated

under

my/our

iv)

The financial information given in the above statement is in agreement

with the relevant register and records; the same has been incorporated
in the books of accounts maintained by M/s................... and their
above mentioned subsidiaries; and is also true and correct.

v)

It has been ensured that the information furnished is true and correct
in all respect; no part of it is false or misleading and no relevant
information has been concealed or withheld;

vi)

Neither I, nor any of my partners is a partner, director, or an employee

of the above-named entity or its associated concerns;

vii) I/we fully understand that any statement made in this certificate, if
proved incorrect or false, will render me/us liable to face any penal
action or other consequences as may be prescribed in law or otherwise
warranted.
viii) I/ We verify that in case the status of Export House is being claimed
under the reduced export performance criteria of Rs. 5 crores average
FOB/ FOR in the preceding three licencing years, the exports have been
made by * (a)Units in Small Scale Industry/ (b) Tiny Sector/ (c)Cottage
Sector or (d)Units registered with KVICs or (e)KVIBs or (f)Units located
in North Eastern States, (g) Sikkim and (h)J&K or Units exporting (i)
handloom, (j) handicrafts, (k) hand knotted carpets, (l)silk carpets or
(m)exporters holding golden status or
(n)exporters exporting to
countries in Latin America as listed in Appendix 17 C and (o) CIS/
(p)sub Saharan Africa or (q)Units having ISO 9000 (series)/ WHOGMP/
HACCP/ SEI CMM level II and above status or (r)service exporters or (s)
agri exporters (other than grains).
(* Strike out whichever are not applicable)
Signature.............................
Place..........
Tel.No. ............................
App.20

Official
Date...........
Stamp/ Seal
Regn. No. and Date of the Corporate Membership..........
-----------------------------------------------------------------------------Documents to be enclosed with the application form:
-----------------------------------------------------------------------------1.
2.
3.
4.

Self certified copy of a) project approval or b) classification approval

of Department of Tourism or c) Any other registration. However, for
Hotels, RCMC from FIEO is acceptable.
A certificate from Chartered Accountant/Cost and Works Accountant
certifying the export/import performance in the prescribed format.
Copy of the FIRC issued by the Bank in respect of foreign exchange
received from service rendered. This would not be applicable to the Hotel
Industry.
Copy of the balance sheet filed with Income Tax Authorities for the
relevant year or CA certificate from the statutory authorities.

App.20

APPENDIX 17 B
BANK CERTIFICATE OF EXPORT REALISATION/ DEEMED EXPORTS FOR STATUS CERTIFICATE
Please see paragraph 3.2.3 of Handbook (vol.1)
To ______________________(Name and Address of the Licencing Authority)
We________________________(Name and Address of the Exporter) declare that we
have forwarded export bills/ banking instruments to ____________(Name and
Address of the Bank, Branch, City) for collection/ negotiation/ purchase. The
proceeds against these documents/ instruments for exports/ deemed exports for
the financial year ending *_________ amounts to Rs.__________________(figures
and words rounded off to nearest lakh).
We further declare the aforesaid particulars are correct to the best of our
knowledge & belief.
Date_____________
Place_______________

Signature of exporter______________
Name_______________________________
Designation________________________
Full Address_______________________
_______________________

BANKS CERTIFICATE
Authorised Foreign Exchange Dealer
Code No allotted to the bank_by RBI vide the following details:
RBI__________________
Ref No:______________
Date:_________________
Place:_________________
This is to certify that we have verified the relevant export
attested EP copy of the shipping bill ad other relevant
_______________________________and the exports/ deemed
declared by the exporter amounting to Rs ___________lakhs
words) for the year ____________ are found to be correct.

invoices, customs
documents of M/s
export proceeds
(in figures and

_____________________
(Signature of bankers)

______________________
(Full Address of Bankers)
Branch and City______________
Official Stamp________________
Note: 1)
* FOB/ FOR actually realised for the concerned financial year to
be given in all cases. The year shall be the second year of exports while
considering the three-year period referred to for claim of status.
App.20

2)

The exporter shall submit a certificate from each of the his bank
branches where he is holding an account where export/ deemed
export proceeds are deposited/ collected.

3)

This is not applicable for service exports.

App.20

APPENDIX 17C
LIST OF COUNTRIES, EXPORT TO WHICH CONFERS DOUBLE WEIGHTAGE FOR THE GRANT OF
STAR EXPORT HOUSE STATUS
Please see note 1 of paragraph 3.5.2 of Exim Policy
SUB SAHARAN AFRICA
S.No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Country
Angola
Algeria
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Canary Island
Cape Verde Island
Central African Republic
Chad
Comoros
Congo Peoples Republic
Djibouti
Equatorial Guinea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guineas Bissau
Ivory Coast
Kenya
Lesotho
Liberia

S.No
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52

26
27

Libya
Malagasy Republic

53
54

Country
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Reunion
Rwanda
Sao Tome
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
St Helena
Sudan
Swaziland
Tanzania
Togo
Tunisia
Uganda
Democratic Republic of Congo
(earlier known as Zaire)
Zambia
Zimbabwe

COMMONWEALTH OF INDEPENDENT STATES (CIS)

S.No
1.
2.
3.
4.
5.
6.

Country
Azerbaijan
Armenia
Belarus
Georgia
Kazakhistan
Kyrgystan

S.No
7.
8.
9.
10.
11.
12.

Country
Moldavia
Russia
Tajikistan
Turkmenistan
Uzbekistan
Ukraine

App.21

App.21

LATIN AMERICAN COUNTRIES (LAC)

S.No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

Country
Anguilla
Antigua and Barbados
Argentina
Aruba
Bahamas
Barbados
Belize
Bermuda
Brazil
British Virgin Islands
Cayman Islands
Chile
Colombia
Costa Rica
Cuba
Dominica
Dominican Republic
Dutch Antilles
Ecuador
French Guyana
Grenada
Guadeloupe

S.No
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44

Country
Guatemala
Guyana
Haiti
Honduras
Jamaica
Martinique
Mexico
Montserrat
Nicaragua
Panama
Paraguay
Peru
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Surinam
Trinidad and Tobago
Turks and Caicos Islands
Uruguay
Venezuela
Virgin Islands

App.21

APPENDIX 17-D
APPLICATION FORM FOR TARGET PLUS SCHEME
The Appendix would be notified in due course

App.21

APPENDIX 17-E
STATEMENT OF UTILISATION OF TARGET PLUS SCHEME
The appendix would be notified in due course.

App.21