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Annexure II to letter F.No. 609/33/2022-DBK dated 09.01.2023
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Format for data subrnision for Duty Drawback Scheme 2023
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Data to be provided for the export period: 01.04.2022 to 30.09.2022
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Serial No.
Item FieldData to be filled
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1Name of the Manufacturer/ Manufacturer Exporter
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2Complete address of the manufacturing , unit
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3Name and designation of the contact person alongwith mobile number and email
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4IEC/PAN
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5HS Code of the export product at 8 digit level
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6Drawback serial number of the export product
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7Exact description of the product as per Shipping Bill(s)
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8Standard Unit Quantity Code (UQC) of
the export product, per Customs Tariff *
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9Quantity of product exported during the relevant period (in UQCs)
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10Total FOB value of product exported during the relevant period in INR
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11FOB value of export product per UQC
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12Table 1 - Input Details
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Input descriptionInput HS
Code at 8
digit level		Quantity
(in
UQCs)		UQCCIF value in
INR per UQC		Import Ratio
(in %)		Rate of BCDRate of
Cess, if
any,		Rate of
Surcharge,
if any		Total Customs duty paid, in INR, on the
input
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Input 1
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Input 2
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Input …
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13Table 2 - Details of fuel used, including fuel used for captive power generation for manufacturing the export product
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Description of fuel usedHS Code at 8
digit level		Total Quantity UsedUnit of heleasurem
ant		Total Central Excise duty paid, in INR, including Cesses and Surcharges, if anyCentral
Excise duty paid, in INR, per unit of export
product
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Fuel 1
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Fuel 2
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Fuel …
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14Table 3 - Data for cases where multiple models of the export product are covered wider the same CTH at 8 digit level (Refer pars 3 of letter dated 09.01.2023
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Export ProductExport
Quantity in
UQCs		Total
FOB, in
INR		Average
FOB, in
INR		Input 1 (Similar data may be given for Input 2, Input 3, Input ... etc.)
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Input HS Code
at 8 digit level		Item
Description		Rate of
BCD		Rate of
Cess		Rate of
Surcharge,
if any		Total Customs duty Paid, for input 1, in INR, for all models
taken
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Model 1
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Model 2
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Model …
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15Please include additional remarks, clarification, etc. here, if any, with respect to export product, its inputs or its manuacturing process(es) along with supporting attachments / documents
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 Explanatory remarks
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When the data submitted is for a unit of measurement different from Customs Tariff UQC, conversion ratio to Customs Tariff UQC may please be furnished.
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