APPENDIX 14-I-A

APPLICATION FOR SETTING UP EOU/SEZs or UNITS IN SPECIAL ECONOMIC ZONE

Note:
1. Please see Para 6.3.1 to 6.3.3 of the Chapter 6 & Para 7.7.2 to 7.7.4 of Chapter 7 of the Handbook of
Procedures (Vol.-I).
2.

Please read the general instructions given in EOU/SEZ Scheme before filling this application and also
some important guidelines given at the end of this application.

3.

The application may be sent electronically or otherwise. But the same will be treated as incomplete
without its own permanent e-mail and will not be considered.
Indicate Whether The Application Is For

AUTOMATIC APPROVAL

OR

BOARD OF APPROVAL

The application should be submitted to the Development Commissioner of the concerned Special Economic
Zone(for setting up EOUs/units in SEZ) in 3 copies alongwith a crossed Demand Draft of Rs. 5,000/- drawn
in favour of the Pay & Accounts Officer, Ministry of Commerce & Industry, Department of Commerce,
payable at the Central Bank of India, Udyog Bhavan, New Delhi. (NO FEE SHALL BE CHARGED FOR
RENEWEL/ EXTENSION OF LOP/ BROAD BANDING ETC.)

For Official Use only

Application No.

______________________________

Date :

______________________________
Date__________Month____________Year __________

Details of Bank Draft

I.

Amount Rs.

___________________

Draft No.

___________________

Draft date

___________________

Drawn on

___________________
(Name of the Bank)

Payable at

____________________

NAME AND ADDRESS OF THE

UNDERTAKING IN FULL (Block Letters)
Name of the Applicant Firm

_________________________________

Full Address

_________________________________

(Regd.Office in case of limited

companies & Head Office for

_________________________________
_________________________________

others

_________________________________

Pin Code

_________________________________

Tel. No.

_________________________________

Fax No.

_________________________________

Permanent E-Mail Address

_________________________________

Web-Site, if any

_________________________________

Passport No., if any

_________________________________

Name of Bank with Address & A/c No.

_________________________________

Digital Signature

_________________________________

Income Tax PAN

_________________________________

The name and address of each

Of the Director/Partner

_________________________________

II.

NATURE OF THE APPLICANT FIRM:

[Please tick ( ) the appropriate entry]
Government Undertaking/Public Limited Company/Private Limited Company/
Proprietor ship/Partnership/Others (please specify)

Note:-

Copy of certificate of incorporation alongwith Article of Association and Memorandum in case of

companies and partnership deed in case of partnership firms may please be attached.

III.

INDICATE WHETHER THIS PROPOSAL IS FOR

[Please tick () the appropriate entry].
Establishment of a New Undertaking
Manufacturing
[ ]
Services
[ ]
Effecting Substantial Expansion
Manufacturing of New product
Conversion of (i) existing DTA unit into EOU/SEZ
(ii) existing STP/EHTP to EOU/SEZ
(In case of conversion, please attach fact sheet as per Annexure)

IV.

(1)

Location of the proposed undertaking

Full Address __________________________
Pin code

__________________________

(2)

ONLY FOR PROJECTS UNDER EOU SCHEME

(In case the unit is proposed to be located on leased premises, then lease should be obtained from
Government or any undertaking / authority of Government. However in case lease is obtained from
private parties, it shall have a validity period of five years from the date of LUT and the
Development Commissioner shall satisfy himself of genuine nature of the lease.)

(a)

Please indicate if the proposed location is in a Centrally Notified Backward Area [Please tick () the
appropriate entry].
No. ______________Yes_________________ if yes, indicate category

(b)

Indicate whether it is within 25 Kms from the periphery of the standard urban area limit of city
having population above one million according to 1991 census.
Yes_____________ No. __________________

(c)

Is it located in an Industrial Area/Estate designated/set up prior to issuance of Notification No.

477(E) dated 25th July,1991.
Yes_____________No. _____________

(d)

If not, does it come under the category of non-polluting industries as notified by the Govt.
Yes ___________ No. _______________

V.

ITEM (S) OF MANUFACTURE/SERVICE: (Including By-product/Co-products)

(If necessary, additional sheets may be attached)

Item(s) Description

Capacity(Unit = )

________________
________________
________________

unit)
________________
________________
________________

tem Code(ITC HS Code No.)

Not required for service
_______________________
_______________________
_______________________

VI.PRODUCTION (In case of more than one item, supplementary sheets may be used)
Quantity (Unit __________)
(Value (In Rupees)
Not required for service unit)
1st year
2nd year
3rd year
4th year
5th year

___________________
___________________
___________________
___________________
___________________

VII.

Indigenous Requirement:

a)
b)

Capital Goods
Raw material, components, consumables,
packing material, fuel etc. during the
period of 5 years

__________________
__________________
__________________
__________________
__________________
(Value in Rupees)

TOTAL:

-----------------------------------------------

VIII.

FOB VALUE OF EXPORTS

(1 $ = Rs.)
Rupees (lakhs)

US $ (Thousand)

1st year
2nd year
3rd year
4th year
5th year
Total:
IX.

INVESTMENT:
(RS. IN LAKHS)

(a)

Land

________________________

(b)

Building

________________________

(c)

Plant and Machinery

(I)
Indigenous
(ii)

Import CIF value

________________________
________________________
(US $ Thousand)
________________________

(iii)

Total (I) + ii)

________________________

(d)

Details of source(s) of finance,

(both Indian as well as foreign)
for the above investments

X.

WHETHER FOREIGN TECHNOLOGY AGREEMENT IS ENVISAGED

(Please tick ( \/ ) the appropriate entry )
Yes ____________
(I)
(ii)

No_____________

Name and Address of foreign collaborator ____________________

Terms of collaboration
(Rupees lakhs)
(Gross of Taxes)

(a)
(b)
(c)
(d)
(e)
(f)
XI.

Lumpsum payment
Design & Drawing fee
Payment to foreign technician
Royalty (on exports)
Royalty (on DTA sales if envisaged)
Duration of agreement

_____________________
_____________________
_____________________
____________________%
____________________
________________(No.of years)

EQUITY INCLUDING FOREIGN INVESTMENT

(i)
$ Thousand)

(Rs.lakhs)

(a)

Authorized

________________

________________

(b)

Subscribed

________________

________________

(c)

Paid up Capital

________________

________________

Note:

If it is an existing company, please give the break up of the existing and proposed capital structure

(ii)

Pattern of share holding in the paid-up capital (Amount in Rupees)

(Rs. in lakhs)

(a)

Foreign holding

(b)

Non Resident Indian company / Individual holding

(US $ Thousand)

_____________ ___________________

(i)

Repatriable

_____________ ___________________

(ii)

Non-repatriable

_____________ ___________________

(c)

Resident holding

_____________ ___________________

(d)

Total (a+b (i+ii)+c) equity

_____________ ___________________

(e)

(iii) External commercial Borrowing ______________ ____________________

Foreign Exchange Balance sheet

1st
XII.

FOB value of
exports in first
five years

XIII.

Foreign Exchange
outgo on

(I)

Import of
machinery

(ii)

Import of raw
materials and
components

(iii

Import of spares
and consumables

(iv)

Repatriation of dividends
and
profits to foreign
collaborators

(v)
(vi)

Royalty
Lump sum know-how
fee

(vii)
(viiii)

Design and drawing fee

Payment of foreign
technicians

(ix)

Payment on training of
Indian technicians abroad

(x)

Commission on
Export etc.

(xi)

Foreign Travel

(xii)

Amount of interest to be
paid
on
external
commercial borrowing/
deferred payment credit
(specify details)
Any
other
payments(specify details)

(xiii)

Total (i)to(xiii)
Net Foreign
Exchange earnings

2nd

3rd

4th

5th

Total Total
(5 yrs)
In Rs./In Th
Lakhs US$

in five years

XIV.

REJECTS(Only for EOU manufacturing units.)

Generation of Rejects/Sub-standard __________
finished goods
__________
Goods (In case rejects are more
than 5% estimated percentage
with justification may be given

XV.

__________________
__________________
(percentage of 5 yrs production)

(Qty.(Unit = )
__________________ ________________
__________________ ________________
Value (Rs. Lacs)

EMPLOYMENT
(All figures in number)

XVI.

Existing

Proposed

--------------

--------------

a)

Supervisory

Men_______________
`Women_____________

_______________
_______________

b)

Non-supervisory

Men_______________
Women_____________

_______________
_______________

NET FOREIGN EXCHANGE EARNING

Average NFE on FOB value of exports in
5 years

XVII.

_________
_________

MARKETING
a)

Whether marketing tie-up/Buy-back _______

envisaged/finalized(Attach documents,_______
if any)
Yes

________
________
No

b)

Destination of exports (in percentage)_______

_______

G. C. A. R. P. A.
________
________
XVIII
OTHER INFORMATION

i)

Any special features of the project proposal _________________

which you want to highlight
_________________
(please attach the project report, for new units)
_______________________
_______________________
_______________________

ii)(a)

(b)

Whether the applicant has been issued any

_________________
Industrial license or LOI/LOP under EOU/SEZ/
_________________
STP/EHTP scheme if so, please
_________________
give full particulars especially reference number,
date of issue, items of manufacture and
progress of implementation of each project.
Whether the applicant has submitted any
other application for LOI/LOP which is

__________________
__________________

pending with the Board of Approvals.

If so, please give particulars like reference
number, name under which application
made, items of manufacture etc.
iii)

Whether the applicant or any of the

partners/Directors who are also partners
/Directors of another company or its
associate concerns are being proceeded
against or have been debarred from
getting any License/Letter of Intent/
Letter of Permission under the Export and
Import (Control) Act. 1947/Foreign Trade
(Development and Regulation) Act, 1992 / FEMA/
Custom/Central Excise Act.

Place

:_________

Date

:________

Official Seal/Stamp_________________

_________________
_________________

Signature of the Applicant ____________________

Name in Block Letters __________________
Designation

___________________

Tel. No.

___________________

e-mail
___________________
Web-Site, if any
___________________
Full Residential Address_________________

UNDERTAKING
I/We hereby declare that the above statements are true and correct to the best of my/our knowledge and
belief. I/We will abide by any other condition, which may be stipulated by the concerned Development
Commissioner. I/We fully understand that any Permission Letter granted to me/us on the basis of the
statement furnished is liable to cancellation or any other action that may be taken having regard to the
circumstances of the case if it is found that any of the statements or facts therein are incorrect or false. An
affidavit duly sworn in support of the above information is enclosed.
Place:__________

Signature of the Applicant _________________

Date:___________

Name in Block Letters

Designation

_________________

Full Official address

_________________
_________________
_________________
_________________
_________________
__________________
__________________

_________________
Official
Seal/Stamp

__________________

Tel. No.
e-mail Address
Web-Site
Full Residential address

Tel. No

__________________

SOME IMPORTANT GUIDELINES

1.

Additional Information may be furnished by existing domestic units seeking conversion into the
EOU/SEZ Scheme as per annexure.

2.

Normally raw material tie-ups are not insisted upon but this may be necessary in cases, such as
granite/marble/sandstone products where availability of raw materials is contingent upon
Government leases etc.

3.

Normally lumpsum amount up to US $ 2 Million and 8% royalty (net of taxes) as amended from
time to time over a period of five years from the commencement of production is allowed as per the
current EOU/SEZ Scheme on account of foreign technology agreement as per the norms of
Department of Industrial Policy and Promotion. In addition selling agency commission is permitted
as per RBI norms.

4.

Cases involving high outgo of foreign exchange for capital goods and raw materials, the
Government prefers raising of funds through external commercial borrowings.
ANNEXURE
PROFORMA TO BE FILLED IN BY THE EXISTING DTA UNITS SEEKING CONVERSION INTO THE
EOU/SEZ SCHEME

a)
b)
c)
d)

e)
f)
g)
h)

Whether conversion of DTA Unit into the EOU/SEZ has been sought
for the full existing capacity of the unit or the proposal is for partial
conversion.(Please give details of the existing capacity etc.)
Whether any expansion of the DTA unit proposed to be converted into
EOU/SEZ has bee envisaged, if so the extent thereof.(Please give
details of the existing capacity and the enhanced capacity etc).
What is the level of existing exports of the unit proposed to be
converted into EOU/SEZ. (Please give details of export performance
item-wise for a minimum of three previous years)
Whether the DTA unit is already under obligation to export, under:
i) Advance Licensing Scheme;
ii) Import of machinery under EPCG scheme;
iii) Any other Scheme.
(Give all relevant details including total E.O. imposed, the E.O.
discharged till date etc.)
Whether your unit is registered with the Customs or Excise authorities.
(Please give details viz. Reg. No., date etc.)
Are you agreeable to have your whole unit customs bonded as
required under the EOU/SEZ scheme?
Whether you are a merchant exporter or a manufacturer exporter.
(Please give details)
What is the age(year of manufacture)and residual life of items/
machinery already installed in your unit, whether they are imported or
indigenous.(Please attach separate sheets giving item-wise details
with value of the new CG as well as existing value of machinery
presently installed).

Date____________

Signature________________________
Name __________________________

Place __________

Address of the Applicant ____________