The Branch Head,AXIS Bank Ltd.PANIPAT Branch

Dear Sir,

Sub: Application for Remittance against Direct Import Bill.

Currency & Amount Beneficiary Name, Address & Account No. / IBAN.

USD-19826.00 STAR TEXTILES AND GARMENTS (FZE)P.O. BOX 9010, SAIF ZONE, SHARJAH U.A.E.

IBAN NO. : AE92023000001001493467Account No. : 1001493467

Beneficiary Bank Name, Address & SWIFT / Sort Code PurposeCOMMERICIAL BANK OF DUBAIBRANCH- SHARJAH, U.A.E.SWIFT CODE : CBDUAEAD

IMPORT BILL PAYMENT

Foreign Bank Charges OUR / BEN / SHAWe would like to purchase / utilise forward contract no._______________ and remit (Foreign Currency & Amount) USD-19826.00 as above.

We enclose herewith a copy of the Invoice No. _____________________, B/L / AWB No.________________ received by us directly.The required A1 form, duly filled in and Exchange Control Copy of Bill of Entry No.1. 5375939 DATED 24/05/2016 2. 5289615 DATED 17/05/2016 3. 5335419 DATED 20/05/2016 in support of the said remittance are enclosed.We request you to debit my/ our EEFC / RFC Account No.__________________________ for USD-19826.00 and the balance amount to my/ our INR Account No.916020008969169 along with your charges.DECLARATION – CUM – UNDERTAKINGThe goods imported/being imported by us are not covered under Negative list of imports as mentioned in Export import policy 2009-2014 and amendments there to till date.We are eligible to import the above- mentioned goods under the current Export and Import Policy in Place.The said goods imported/being imported by us are not restricted for import through specific licensing under the above-mentioned policy and amendments.I/We declare that the captioned transaction does not involve and is not designed for the purpose of any contravention or evasion of the provision of the Foreign Exchange management Act 1999 or any rule, regulations, notification, direction or order issued there under.I/We also hereby agree and undertake to give such information/documents as will reasonably satisfy you about this transaction in terms of the above declaration. I/We also understand that if I/We refuse to comply with any such requirement or make only unsatisfactory compliance therewith, the bank shall refuse in writing to undertake the transaction and shall if it has reason to believe that any contravention/evasion is contemplated by me/us report the matter to Reserve Bank of India.In this regard, we confirm that the HS Code of the goods is 63109040 and mutilation conform to the requirement specified by Customs Public Notice or Trade Notice.We are unable to submit BOEs of these shipments as goods are not released from Custom and we confirm to submit Bill of Entries within three months from transaction date.*I/We further declare that the undersigned has the authority to give this application, declaration and undertaking on behalf of the firm/company.Thanking you.

Yours faithfully,Date :Place : PANIPAT

Signature: ______________________________Name: ______________________________

Address: ______________________________I.E. Code: ______________________________

Encl.: A1, Copy of Invoice, B/L/AWB, Bill of Entry etc