ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAG
1
.
2
3
 Application for Pharmexcil Outstanding Export Performance Award 2021-22
4
5
1.) Name of Firm
6
2.)Pharmexcil RCMC No.
7
3.) Details of the Official of the applicant company to whom all correspondence would be addressed
8
Name
9
Designation
10
Mobile No.
11
Tele No. (with STD code)
12
Fax No.
13
E-mail
14
5.)Details of Status Holder Certificates (if any, awarded by DGFT under foreign trade policy)
15
6.)Export Details (All figures in Rs. Lakhs, (numerics) . All trading/merchant exports should be in column 9.
16
BREAK UP OF TOTAL EXPORTS SALE AND CONSOLIDATED DOMESTIC SALE IN LAKHS ONLY
17
12345678910111213
18
Financial YearAPI/BULK/ INTERMEDIATES FORMULATIONS (NON BIO)BIO PHARMA INCLUDING VACCINES & MONOCLONAL ANTIBODIESHERBALSAYUSH (FINISHED DOSAGE FORMS OF HOMEOPATHY, AYURVEDA, UNANI,SIDHA)CONTRACT RESEARCH SERVICES ALSO CONTRACT MANUFACTURING(API+FORMULATIONS)NUTRACEUTICALSSURGICALS/DIAGNOSTIC REAGENTS/ EXCIPIENTSMERCHANT EXPORTS(ONLY TRADING TURNOVER)VETERNARY (ALL)SPECIAL FORMULATIONS C/R,S/R,M/R IN SOLIDS/LIQUIDS/INJECTABLES & OTHER MODIFIED TECHNOLOGIES




ONCOLOGICAL FORMULATIONS




 ANTI
TB FORMULATIONS





19
2021-22
20
2020-21
21
2019-20
22
23
14151617181920212223242526
24
Financial Year ANTI
MALARIA
FORMULATIONS


 ANTI-DIABETIC DRUGS FORMULATIONS

LAC (All Categories)Africa (All Categories)CIS (All Categories)ASIA (All Categories)OCEANIA (All Categories)NORTH AMERICA (All Categories)EUROPE (All Categories)MIDDLE EAST (All Categories)TOTAL EXPORT SALES (1+2+3+4+5+6+7+8+9+10)Domestic SalesGRAND TOTAL (24+25)
25
2021-2200
26
2020-2100
27
2019-2000
28
contd…
29
NOTE:Actual EXPORTS( Physical products) leaving India shores by value alone are eligible. Exports value of Subsidaries located outside India are not te be included.
30
31
Date:
Signature, Name, Designation and Stamp
32
Note: Classifications of Regions (see table Overleaf)
33
--2--
34
Instructions:
35
A.Soft copies of Application , all documents are to be submitted by email to stats@pharmexcil.com and to be followed by hard copies.
36
B.Only Soft copy excel format of the application should be used to submit the details and the same should not be modified in any way(NO PDF PLEASE)
37
C.All figures should be quoted only in Rs. Lakhs rounded of to nearest Lakh. No decimal values please.
38
D.Merchant exports should be given separately under the heading provided.
39
E.Published annual reports of the company may be sent as certified by auditors. in case of private companies, pl get them certified by a ca/icwa/acs/cpa/ cfa for exports performance figures . For the latest financial year in case Audited reports are not available certified provisional reports may be submitted.
40
F.Last Date of Submission is 31st May 2023
41
G.Attach Brochures of the company and 1 page note giving brief profile of the company.
42
H.Only one application per group or company is permissible.
43
I.Any application not conforming to the above instructions would be summarily rejected.
44
J.The Right of Selection and decesion of confering the award lie with the committtee and not open for contest and/or discussion.
45
46
Classifications of Regions
47
LACAFRICACISASIAOceaniaNorth AmericaEUROPEMiddle East
48
ArgentinaAlgeriaArmeniaBruneiAustraliaCanadaAustriaBahrain
49
BoliviaAngolaAzerbaijan
Cambodia (Kampuchea)
FijiUSABelgiumDjibouti
50
BrazilBeninBelarusIndonesiaGuam
Antigua and Barbuda
BulgariaEritrea
51
ChileBotswanaGeorgia
Korea DPR (North)
KiribatiBahamasCyprusIran
52
ColombiaBurkina FasoKazakhstanLaos
Marshall Islands
British Virgin Islands
Czech RepublicIraq
53
Costa RicaBurundiKyrgyztanMalaysiaNew Caledonia
Cayman Islands
DenmarkIsrael
54
CubaCameroonMoldova
Myanmar (Burma)
New ZealandDominicaEstoniaJordan
55
Dominican Republic
Central African Republic
RussiaPhilippinesPalauGrenadaFinlandKuwait
56
EcuadorChadTajikistanSingapore
Papua New Guinea
JamaicaFranceLebanon
57
El Salvador
Congo P. Republic
TurkmenistanThailand
Portuguese Timor
MontserratGermanyMorocco
58
GuadeloupeCongo, D.R.UkraineViet Nam
Saint Kitts and Nevis
GreeceOman
59
Guatemala
Cote d'Ivoire (Ivory Coast)
UzbekistanAfghanistanSaint LuciaHungaryQatar
60
GuyanaEgyptChinaSaint VincentIrelandSaudi Arabia
61
Haiti
Equatorial Guinea
Hong KongSurinameItalySomalia
62
HondurasEthiopiaJapan
Trinidad and Tobago
LatviaSudan
63
MartiniqueGabon
Korea Republic (South)
LithuaniaSyria
64
MexicoGambiaMacauLuxembourgTurkey
65
Netherlands Antilles
GhanaMongoliaMaltaUAE
66
NicaraguaGuinea
Taiwan (Taipei)
NetherlandsYemen
67
PanamaKenyaTongaPoland
68
ParaguayLesothoBangladeshPortugal
69
PeruLiberiaBhutanRomania
70
Puerto RicoLibyaMaldivesSlovakia
71
Uruguay
Malagasy (Madagascar)
NepalSlovenia
72
VenezuelaMalawiPakistanSpain
73
MaliSri LankaSweden
74
MauritaniaUK
75
MauritiusAlbania
76
MozambiqueAndorra
77
NamibiaSouth Africa
Bosnia-Herzegovina
78
NigerSwazilandCroatia
79
NigeriaTanzaniaFaeroe Islands
80
ReunionTogoIceland
81
RwandaUgandaMacedonia
82
SenegalZaireMonaco
83
SeychellesZambiaNorway
84
Sierra LeoneZimbabweSerbia
85
contd…
86
--3--
87
88
89
90
91
Items No 11,12,13,14 & 15 are different dosage forms. They are as follows
92
C/R Stands for controlled release, S/R stands for sustained release,M/R stands for Modified release
93
94
8)
95
96
97
98
99
9) To be filled only by companies applying for woman enterprenuer award
100