Declarations of Suppliers - Import Content - SPSI

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<On the Letterhead of the Supplier>

Date: ……………
To,
Hutchinson Industrial Rubber products Pvt Ltd
Plot 600A, Indospace Industrial Park Oragadam, Block B, Panrutti Village,
Oragadam- Wallajabad Road, Sriperumpudur Taluk, Kancheepuram – 631604
Tamil Nadu – INDIA
Sub: Declaration of import in the parts / components / aggregates
Usage of Import parts / components
If No, Please Strike Out the Below line and ignore the below details.
If Yes, Please Declare the Below details.
1. This refers to the import content confirmation of self, our Tier-II and
Tier-III suppliers requested by your company, which is required by our
customer (TATA) for the purpose of declaration to the Ministry of Heavy
Industries (MHI), Government of India and its Agencies including
Testing Agencies, in relation with requirement of localization under the
Production Linked Incentive (PLI) Scheme for Automobile and Auto
Component Industry in India (PLI-AUTO).

2. The details of part-wise import content are as follows:

Value
Value of Broad
Selling of Broad
parts Description
Price in Direct Description
Part Part imported of parts Local
INR Import of parts DVA%
No. Description by our imported Content
(excluding by us imported
suppliers by our
GST) (in by us
(in INR)* suppliers
INR)*
(A) (B) (C) (D) =(A-B-C) (D/A)
ABF339/356A4
Outer Tube
1
ABF337/313A2
Small Bush Inner
6
* Import Value = CIF + Import Duty (but excluding GST). Imports will
include royalty, license technical know-how expenses and imported
services, in line with the declarations made under GST.

3. Our IEC Code: _________

4. The above declaration is based on following:


Reference Rate of Foreign Exchange (please enclose separate sheet if
required):

i. Currency Name _______


ii. Reference Date _______
iii. Foreign Exchange Rate_____

5. The above declaration is furnished We certify that the aforesaid


information is true and represents a fair picture.

6. In the event of any material change in the percentage of import/ local


content declared above, we undertake to notify you at the earliest. The
import content has also been verified.

<Signature of Supplier>

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