Customs Rules
The Customs and Central Excise Duties Drawback Rules, 2017

ANNEXURE-II

APPLICATION FOR SUPPLEMTARY CLAIM FOR DRAWBACK UNDER RULE 16

(Where the drawback received falls short of the rate finally fixed by the Government, application for supplementary claim of drawback should be made in the following form)

The Assistant/Deputy Commissioner of Customs-in-charge

Drawback Department

We hereby make a supplementary claim for drawback of Customs/Central Excise which has been less paid to us as explained therein.

1	Exporter
(a)	Name
(b)	Address
(c)	Telephone No.
(d)	Name of Clearing Agent
2	Goods Exported
(a)	Description
(b)	Quantity
(i)	Gross
(ii)	Net
(c)	Marks & No.
(d)	Destination
(e)	Shipping Bill No. & Date
3	Vessel
(a)	Name
(b)	Rotation No.
4	Drawback already paid
(a)	Amount
(b)	Custom House Reference No.
(c)	Quantity/Value on which allowed
(d)	Rate at which allowed
5	Drawback not claimed
(a)	Amount
(b)	Quantity/Value on which allowed
(c)	Rate at which claimed
6	Reason for the supplementary claim.
7	No. of documents enclosed*

DECLARATION

1. I/We hereby declare that the supplementary claim of drawback is based on the Customs and Central Excise duties paid on the raw materials used in the manufacture of goods exported and that the duties so paid have not been claimed as rebate under the Central Excise Rules, 2002.

2. I/We hereby declare that the declaration made herein is true and correct.

	Signature
	Designation

* Please enclose copy of communication regarding rate of drawback determined under rule 6 or 7, any other document in support of supplementary claim, or other documents as may be prescribed by Principal Commissioner/Commissioner of Customs. Please also enclose calculation sheet.