Date: ___/___/2019

To,
The Principal Commissioner of Customs
Custom House,
Mundra/Kandla.

Subject : One Time Authority Letter and Declaration

Reference : Import/Export Consignments
: I.E.C. No. ________________________
IGST. NO. _______________________

Dear Sir,

We hereby appoint M/s. ASHAPURA LOGISTIC SOLUTION, as our Customs Broker (C.B) in terms of CBLR 2018 to file our
bill of entry/shipping bill on our behalf and represent us before Customs and other allied agencies to complete all the
and limited to documentation formalities up to delivery of the import consignment or export of export consignment at
Customs station on our behalf.

We declare that in terms of Regulation 10(d) of CBLR 2018 we have been advised by our CB to read and understand all
relevant laws for its compliance and accordingly we declare that we have read and understood Customs Law , Foreign
Trade policy/Procedure, FEMA and other Law time being in force in India for import/export shipments and with regard
to all the provisions prescribed under the aforesaid laws, we state that our declarations and documents submitted
herewith are true complete and correct in all respect and nothing has been concealed or attempted to be concealed or
attempted to be concealed or suppressed or mis-declared from Customs and or any other authority.

We have full knowledge of law and accordingly we hereby declare that filing of accurate and correct declarations in
terms of Section 46 for import and Section 50 for export is the sole responsibility of the importer/exporter and
accordingly we have compiled with the requirements of the Custom Act and the provisions of Self-Assessment as well as
for single window Scheme to take release of goods from participating other government Agencies (PGA’s) by submitting
herewith correct and accurate declarations and documents including documents uploading in E-Sanchit.

We hereby state and declare that description of goods, claim of classification (CTH), declaration of value as per valuation
rules of Customs,duty exemption or other notifications,export incentive benefits, appropriate drawback rate,
compliance of PGAs etc in the bill of entry/shipping bill are as per our instructions and documents provided by us. We
being the owner/importer/exporter of the goods take ones/responsibility/liability for the same. We have verified the
checklist prepared & provided by our CB in terms of Customs Act (Self-Assessment (RMS)) and all applicable laws and
herewith given our approval and instructions for filing of documents through ICEGATE with customs Authority as per the
checklist provided to us.

We hereby declare that C.B was not been consulted in any manner what so ever while placing/receiving order to/from
our overseas supplier/buyer and also at the time of importation/exportation of goods into India/from India or likewise
similar goods or catalog or brochure have not been physically produce or shown to or discussed with our C.B with regard
to this shipment Appointment of C.B under this Authority letter/Declaration is specific to and limited to carry out only
the process of preparation B.E/S.B on the basis of documents provided by us and to complete documentation formalities
for clearance of import/export goods from Customs Authority at Customs station as per Section 146 of C.A 1962.
We further state and declare that in case of any investigation take place by any agency due to irregularities or mis-
declarations found in our above reffered shipment or in any of the documents or declarations or cargo presented
therewith, we shall be solely liable for all/any penal action including monetary or otherwise in terms of provision made
under Customs Law and all Allied Acts and in such case the said Customs Broker shall stand totally absolved of any
responsibilities/liabilities whatsoever. We also undertake to attend, reply and comply with any post clearance audit
queries, duty less charge demand (if any raised) based on the declarations made by us in this regard at the time of
clearance of present/onward shipments.

Thanking you

Yours truly,

For, COMPANY NAME

Name of Signature Person

Authorized Signatory

Note: The said letter is to be provided either Bank Attested or through Notary.