1
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Production Sharing Contract (PSC) No. and Date with block reference
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2
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Name & Address of the Operator/ Contractor
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Reliance Industries Limited.
3rd Floor, Maker Chamber IV,
222 Nariman Point,
Mumbai -400 021, India
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Other Constituent Company:
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3
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Name & Address of Sub - Contractor
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4
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No. and date of Sub - Contract /PO / SO entered into…and…with validity Period
( Copy enclosed / sent )
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Dt , Attached Copy,
valid Till
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5
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FOB/CIF Value of Import as per list of goods (foreign currency) give FOB value
only where CIF value not available)
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CIF
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6
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Equivalent value in Indian Rupees FOB / CIF
Exchange Rate =
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CIF
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7
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Technical write up with justification for present import.
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Attached
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8
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If Import is under negative list,Please attach permission from CCOE /
DGFT / DGCA / AERB as the case may be.
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9
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Whether items for re-export, if yes please give month of re-export.
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10
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Details of past import effected of these items indicating total import, consumption
and balance. (EC Nos. to be mentioned).
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End Use /Consumption report shall be submitted to DGH, as undertaken vide
our letter Dt. 29-Sept-05.(Ec No -)
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11
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Particulars of Essentiality Certificate (s) already obtained for execution
of the above contract (Statement is enclosed).
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12
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Whether item of import is by operator on behalf of joint venture or in individual
capacity.
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13
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Specified place / destination of use of items of present import.
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14
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Port of un-loading with name of Customs Commissionerate concerned. (Separate
application for Sea and Air)
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a)
b) The Deputy Commissioner of Customs
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It is Certified
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(a)
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That the goods included in Annexure 'A' to this application are imported in
connection with petroleum operations undertaken under a contract with Government
of India and as such quality for the exemption of duty under SI.No. of Notification No. Cus. Dt. and as
amended thereafter.
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(b)
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That the present import is within the work programme and budget duly reviewed
/ approved by Management committee for current financial year.
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(c)
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That goods imported are not available in India on terms equal to or better
than imported goods with respect to time of delivery quality and quality required,
prices etc.
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DECLARATION / UNDERTAKING
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1
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I/ We hereby declare that the goods will only be utilised in connection with
petroleum operations undertaken under a contract with Government of india and that
these goods will not be used anywhere else without the approval of DGH and Custom
authorities.
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2
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I / We will comply with the condition No. specified under Custom Notification No. Cus. Dated and relevent
clause of Production Sharing Contract (PSC).
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