EXP

EXP FORM

(Statutory declaration to be furnished by exporters under FE Regulation Act, 1947 before shipment of goods. An incorrect declaration constitutes offence under the said Act.)

First Original
(To be submitted to the Customs with Second Original duly completed and certified by the Authorized Dealers)

EXP NO.

AD’s Code				Serial Number					Serial Year

Name and address of the Authorized Deale

I/We, the undersigned hereby declare that I/we am/are the sellers/consignors of the goods described below in respect of which this declaration is made out and that the particulars given in the following items are true and that the invoice value declared in SI.No.5 in case of firm contract is full value as contracted with the buyers; and in case of consignment sale, is a fair value of the goods which are being shipped on consignment sale.

I/We do hereby undertake to repatriate full proceeds of the export within the period specified by the Bangladesh Bank in terms of FER Act.

Sl. No.	Items		Particulars (to be filled in by Exporter)	Code No. (to be filled in by Authorized Dealer)
1.	Commodity to be exported
2.	Country of destination
3.	Port of destination
4.	Quantity	Unit (bales/tons/lbs. etc.)
4.	Quantity	Volume (Weight/number etc.)
5.	Value	Currency
		Incoterm Used
		Invoice Value		FOB	Insurance	Freight
		Invoice Value
		CMT Value (if applicable)
6.	Terms of sale (Firm Contract/LC or Consignment sale)
7.	Name & address of importer/consignee
8.	Name of carrying vessel
9.	Bill of Lading/Railway Receipt/Airway Bill/Truck Receipt/Post Parcel Receipt		No.: Date:
10.	Port of shipment/Post Office of despatch
11.	Land Custom Post
12.	Shipment date
13.	Name of the Exporter (in block letter) with address
14.	CCI&E’s Registration Number of the exporter and date
15.	Sector (Public or Private) under which the exporter falls

Authorized Signature and Stamp of the Exporter with date

Coded by

Checked by

(Signature of authorized official of the bank)

Certificate of Authorized Dealer

Certified that the above exporter(s) is/are known to us, that he/they is/are bonafide businessman/men in Bangladesh and that he/they has/have made arrangements with us for the realization of the export proceeds of the goods declared on this form within the stipulated period and that we are satisfied with the said arrangements. We have also satisfied ourselves about the bonafides of the importers/consignees abroad and their credentials etc.

*We undertake that for export shipments on consignment sale, we shall obtain from the exporter(s) and furnish to the Bangladesh Bank a fully documented account sale certified by the consignees/Chamber of Commerce of the country of import.

*We further undertake that in the event of non-realization or short realization of export proceeds against shipment within the stipulated period, we shall obtain from the exporter(s) and furnish to the Bangladesh Bank full explanation as to the circumstances resulting in non-realization/short realization.

*(Strike out the portion not applicable and authenticate with initials).

Date

Stamp and Signature of
Authorized Dealer

(TO BE COMPLETED BY CUSTOMS/POST OFFICE)

1. Month in which this item is included in the Customs/Post Office Return

2. Value assessed by the Customs/Post Office

3. Shipping Bill/Airway Bill/Post Parcel Receipt No

Dt.

Seal

Signature of Custom Officer

Date

(TO BE COMPLETED BY CUSTOMS/POST OFFICE)

(Applicable where advance payment or irrevocable or confirmed Letter of Credit is required in cover of the shipment.)

1. An irrevocable/confirmed Letter of Credit No.

for

has been opened covering the shipment described on page No. 1.

2. Remittance for

has been received as per method No.

as indicated below on

and has been allocated against the shipment described on page No. 1.

(i) in Taka from a Non-Resident Bank A/C.

(ii) in Foreign Currency on

Amount

Date

Stamp and Signature of
Authorized Dealer