Appendix-20 of Volume -2

EXP FORM NOT ATTACHED VOUCHER

NAME AND ADDRESS OF AUTHORISED DEALER ……………

 

 

 

Sl. No.

Items

Particulars

Code Number

1.

EXP Form Number

 

2.

Name of the address of the exporter (in block letter) with address

 

 

 

 

3.

CCI & E's Registration No. and date of exporter

 

4.

Sector (Public or Private) under which exporter falls

 

 

5.

Name of the foreign buyer

 

6.

Commodity to be exported

 

 

 

 

 

 

 

 

7.

Country of destination

 

 

 

 

 

8.

Port of shipment

 

9.

Amount of Export proceeds realised

Currency in which realised

 

 

 

Amount realised

 

Date of realisation

 

10.

Reporting period

 

 

 Date ……………….

Signature and Stamp of the
                                                                                        Authorised Dealer