Application No.

: 536134383032300824043122

Format of Softex Forms

Summary Sheet

(Section - A)

Name and address of the Exporter Sackore ,Sahajanand Nagar Infornt SSD IEC Code. AMSPH8477N
Baglow Arjun Nagar Amravati
Maharashtra,Amravati,444601
Letter of Permission (LOP) No. (NSTP Unit) STPI/NSTP/NPR/24802 Date of LOP Issued 26-08-2024
Name of Authorized Datacom Service Provider BHARTI AIRTEL LIMITED STPI/SEZ Center NAGPUR
Name and Address of Authorized Dealer/Bank STATE BANK OF INDIA, RUKHMINI NAGAR Authorized Dealer Code 00167556440008

(Section - B)

List of Invoices for offshore export value through datacom link

Period of Invoices raised from (01-Jul-2024) To (31-Jul-2024)

Sno. Softex No. Name of Address of Country Internal Type of Mode Of Invoice Invoice Currency Analysis of Export Value
the Client the Client project S/W realisation Number Date Value Of Transmiss Commissi Deduction Net
code/Cont Exported (DD/MM/ Software ion on (C) (D) Realisable
ract/ YY) Export (A) Charge Value[(A+
Agreeme (B) B)-(C+D)
nt No
& date
1 S2400696 PREMIND Laukaanti FI PRESAC2 909 3 A2907202 27/07/24 EUR 9250.00 0.00 0.00 0.00 9250
9754 OY e4A 540610 & 4
Jyvskyl Fi 15-05-202
nland-403 4
20

Total No. of Invoices:1

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 (Section - C)

DECLARATION BY EXPORTER

I/We hereby declare that I/we am/are the seller of the software in respect of which this declaration is made and that the particulars given above are true and that the value to be received from the
buyer represents the export value contracted and declared above. I/we also declare that the software has been developed and exported by using authorised and legitimate datacom link and certified
that the software described above was actually transmitted.

I/We undertake that I/we will deliver to the bank named above the foreign exchange representing the full value of the software exported as above on or before 9 months(i.e. within the period of
realisation stipulated by RBI from time to time), in the manner specified in the Regulations made under the Foreign Exchange Management Act,1999.

I/We am/are not in the Caution List of the Reserve Bank Of India.

Place : Amravati
Date : 10-09-2024
Name : Piyush Devendrakumar Harne
Designation : PROPRIETOR
Application No. 536134383032300824043122 (1)
Signature Of the Exporter
Stamp

Certified, on the basis of above declaration by the SEZ/STPI unit, that the software described above and the export value declared by the exporter in this form is as per the corresponding
invoice/gist of invoices submitted and declared by the Unit.

Place : NAGPUR
Date :
Name :
Designation :

(Signature of the Designated/ Authorised Official of STPI/EPZ/SEZ)

Stamp

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