IMP

IMP NO.	AD's Code	Serial No	Year
IMP NO.

FOREIGN EXCHANGE REGULATION ACT, 1947 Application for permission under Section 4/5 of the Foreign Exchange Regulation Act, 1947 to purchase foreign exchange for payment of imports

Form IMP For Imports only

[Original copy for AD's matching with Authenticated Copy of Bill of Entry/Customs certified invoice]

Name and address of the Authorized Dealer effecting the remittance

I/We, the undersigned hereby apply for permission to remit

For goods imported/to be imported by us/me as per details given below against LC/Contract No

Date

LC Authorization Form

Registration No. with the AD

Description of goods

HS Code No

Quantity of goods

Invoice value in foreign currency**

Number

Date

Value in Tab

Unit

Quantity

FOB

Freight

Insurance

Others, if any (Pls. specify)

Total

7	8	9	10	11	12	13
Country of origin	Incoterm used	Port of Shipment	Name of Steamer/Airlines and date of shipment (if goods are sent by post state so)	Port of importation in Bangladesh or name of country of ultimate destination if other than Bangladesh	Indenter’s name and address	Indenter’s Registration No. with
						CCI&E	Bangladesh Bank

*For more than one HS Code, a separate sheet should be added.

** (a) ADs shall report FOB value, freight, insurance and other charges separately in Bangladesh Bank reporting system as per Circular Letter No. FEPD(Import)/125/2013-35 dated December 10, 2013. (b) ADs shall report FOB value of goods in Schedule E-2/P-2 or relevant schedules, and freight, insurance and other charges in Schedule E-3/P-3 or other relevant schedules mentioning IMP Form number.

1. I/We declare

(a) That the above payment is due and that I/we have not already obtained exchange for payment of (any of) these goods, nor have I/we made any other application for that purpose.

(b) The amount of Foreign Exchange mentioned above represents the correct prevailing market price for these goods on the date of contract in country of Export.

(c) That I/we am/are neither connected with the exporters abroad directly or indirectly nor do I/we have any financial or other interest in the exporters abroad.

2. I/We certify that the above import is covered by a valid L.C. Authorization Form.

3. I/We undertake to clear the goods for consumption in Bangladesh \\thin four months of the date of this application and shall, before the expiry of that period, surrender to the Bangladesh Bank through yourselves the AUTHENTICA TED COPY/IES OF THE CUSTOMS' BILLS OF ENTRY FOR CONSUMPTION INBANGL<\DESH or certified invoice/s covering the above goods, along with the Duplicate copy of this form (See note (a) below).

4. I/We declare that the statements made in this application are true to the best of my/our knowledge and belief.

5. I/\We assume full responsibility for complying with the provisions of the Foreign Exchange Regulation Act, 1947.andrules, orders and directions made or issued thereunder.

Full name and address of the applicant

Registration No. with C.C.I. &E

Date

Importer's VAT Registration (BIN) No

Date

Signature and Stamp of the Importer

(This form shall be signed by the Importer or his authorized Agent)

(To be completed by the authorized Dealer)

1. We hereby certify that the statements made by the applicant in this form are to the best of our knowledge correct and that we have seen documentary evidence in support thereof.

2. The remittance has been made in accordance with method of payment as per existing Foreign Exchange Regulations.

Date:

Signature and Stamp of the Authrized Dealer

Bangladesh Bank Approval No.

Date

Approved for

N.B: (Bangladesh Bank approval will remain valid for 30 days from the date of approval)

(CODING OF THE TRANSACTION BY AUTHORIZED DEALER)

Month	Country Receiving Payment	Country of origin of goods	Commodity	Quantity of goods		Place of importation	Type of LCAF	Currency	Amount
Month	Country Receiving Payment	Country of origin of goods	Commodity	Unit	Quantity	Place of importation	Type of LCAF	Currency	Amount

Coded By

Checked By

Date:

Signature and Stamp of the Authrized Dealer

NOTE FOR IMPORTERS:

(PLEASE READ CAREFULLY)

(a) IMP Form are in one set. The importer should complete and sign of the form and hand them over to the Authorized Dealer (Bank) through whom the remittance is being made.

(b) The form should he completed in every required detail. There should be no alterations or deletions in the wording of the form except where provided. The form should be signed by the Importer or his Authorized Agents holding Power of Attorney from the original importer. Importers are advised that a false statement on this form constitutes an offence under Section 22 of the Foreign Exchange Regulation Act,1947. Omission of essential information constitutes a false declaration.

(c) The attention of Importers is drawn to sub-section 3 of the Section 4 of the Foreign Exchange Regulation Act, 1947. Exchange sanctioned for a particular purpose must be utilized for that purpose only and all conditions attaching to the sanction must be complied with. If any of the prescribed conditions cannot be fulfilled and as a result the exchange cannot be utilized in whole or in part for the purpose for which it was sanctioned, the unutilized amount must immediately be refunded through an Authorized Dealer in foreign exchange in Bangladesh.