APPENDIX - 3 B
------------------------------FORM OF REGISTRATION-CUM-MEMBERSHIP CERTIFICATE
----------------------------------------------------------------------Note: Please see Paragraph 4.10 and 13.8 of the Policy and Paragraph
13.3 of this Handbook
----------------------------------------------------------------------PART I
(To be filled in by the applicant)
1.
Name and address of the applicant :_______________________________
2.
IEC Number
:_______________________________
2(A) PAN Number
: _____________________________
3.
:_______________________________
Address of the Head Office
_______________________________
(i) Registered
Office
:______________________________
(ii) Branch(s)
:_______________________________
(iii) Factory(s)
:_______________________________
4.
Year of establishment
:_______________________________
5.
Description of export product(s)
for which registration is sought
:_______________________________
6.
Whether registration is required
as merchant exporter or manufacturer
exporter
:_______________________________
7.
Name of the Proprietor/Partner(s)/
Director(s)/Karta
:_______________________________
I/We hereby declare that the above information is correct to the best of
my/our knowledge and belief. I/We also undertake to abide by the
conditions subject to which registration/membership is granted.
(Signature)
Name in Block letters _________________________
Designation
_________________________
Residential Address___________________________
___________________________
Place _______________
Date _______________
App.13
PART - II
(TO BE FILLED IN BY THE REGISTERING AUTHORITY)
This is to certify that M/s____________(Name and address of the firm/Company)
is registered with us.
Other details as per our records are as under:
(i)
Description of goods for which registered
_____________________
(ii)
Registration number
_____________________
(iii) Manufacturer exporter or merchant exporter
(iv)
Name(s) of proprietor/
partner(s)/director(s)/
Karta (s)
_____________________
________________________
This certificate is issued subject to the conditions laid down in the
relevant scheme of registration of this council.
(Signature of the competent
officer of the E.P. Council)
Valid/renewed upto
__________
Name
_________________
Designation
_________________
Seal
________________
Date of issue
Space for endorsement of any amendments in this certificate
_________________
App.14