SECTION II

(a) Name of the Importer :

(b) Bill of Entry (B/E) No. and Date

(c) Customs Station where B/E was filed :

(d) Goods on which preferential rate of duty has been claimed :

S.no. Description Classification (8 digit)

Neo Star M-C1S Label Paper 4810.29.00

SECTION III

Part A:

Note 2 : If goods are not wholly obtained, the manufacturing/processing undertaken in country of origin
must be ascertained.

Description of goods. Production process Originating

Criterion
Neo Star M-C1S Label *Coated Paper: CTSH+RVC35
Paper CTSH+RVC35
1) Pulping – 2) Paper Making – 3) Coating –4) Cutting & CTSH+RVC35
Packaging CTSH+RVC35
1) Pulping : The process of mixing pulp and other material, CTSH+RVC35
which are the main ingredients of paper, at an appropriate CTSH+RVC35
concentration to turn them into turbid solution. CTSH+RVC35
CTSH+RVC35
2) Paper Making : The process of making materials that are in CTSH+RVC35
turbid state into paper conditions through dehydration and drying CTSH+RVC35
processes at the paper machine.

3) Coating : The process of applying a coating liquid solution

and processing it into a coating paper.

4) Cutting & Packaging : The process of finalized product from

paper products by cutting them into rolls and sheets.
 Part B:

1. State the following information for each originating material or component used in production of
good subject to this request. If no originating material/components were used, same should be
indicated as “None”.

Description of good under import and its classification (8 digit)

Description of the Whether Whether In case procured

originating Materials or manufactured by procured by from third party, did
Component producer of final producer producer of final
good locally from a good seek
third party conformation and
documentary proof of
origin of these
component?
(Yes/No) (Yes/No) (Yes/No)
HW PULP No No Yes
SW PULP No No Yes
BCTMP No No Yes
CLAY No No Yes
Calcium Carbonate_65F60 No Yes Yes
Calcium No Yes Yes
Carbonate_HYDROCARB-60
Latex_DTO6115 No Yes Yes
Maize (corn) starch No No Yes
fluorescent dye stuff_white L No No Yes
fixative _OPAZIL AOK No Yes Yes

Note : If origin of any of components used in manufacture of final good cannot be ascertained, same
should be treated as non-originating.

2.
a. Is the de minimis provision used to
determine whether the good subject to this
request qualifies as an originating good?
b. Is the accumulation/cumulation provision
applied to determine whether the good
subject to this request qualifies as an
originating good?
o Yes
• No
If yes, describe such material and the
percentage value or quantity as applicable.
• Yes
o No
If yes, describe the manner and extent of
cumulation.
Apply the “Bill of Material” and
approved by the Authorization
“Bill of Material” is included material,
quantity, price, manufacturer and
documentary proof..
c. Has any other additional criteria such as o Yes
indirect/neutral materials, packing materials, • No
etc. used in ascertaining whether the good
If yes, provide the criteria used:
qualifies as an originating good.
Describe the material concerned:
d. Is the originating criteria based on value • Yes
content?
o No
If yes, provide the following:
(i) percentage of local value content:
39.35%
(ii) components which constitute value
addition
Material, profit, labour, overhead cost
e. Has CTC rule been applied for meeting • Yes
originating criteria?
o No
If yes, provide HS of non-originating
material/components used in production of
good:
4703.21
4705.00
2507.00
1108.12
3204.20
f. Has process rule been applied in ascertaining o Yes
origin of good subject to this request? • No

If yes, provide the rule applied:

g. Has the CoO been issued retrospectively? o Yes
• No
If yes, provide reasons for same:
h. Has the consignment in question been • Yes
directly shipped from country of origin?
o No

If not, then has it been ascertained that

same is as per provisions of the concerned
agreement?
How has it been ascertained that goods
have met the prescribed conditions of
Direct Shipment?