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APPENDIX - 2

PROFILE OF EXPORTER/ IMPORTER


FOR OFFICIAL USE

File No:--------------------------------- Date:-------------------

Note: To be submitted once alongwith the first application and to be


submitted subsequently only in case of any change in the
information already submitted. RLAs to enter this information in
the computer so as to dispense with the need of repetitive
declaration.
--------------------------------------------------------------------------

1. Name of the applicant :...................................

2. Address of the applicant :...................................


(Registered Office in :...................................
case of limited companies, :...................................
and Head Office :...................................
for others )
Tele No.:...........................
Fax No :...........................
E.Mail address: ...................

--- --- --- --- --- --- --- ---


3. Date of establishment of | | | | | | | | |
business/factory in India --- --- --- --- --- --- --- ---
d d m m y y y y

4. IEC No. .........Date of Issue ........ Issuing Authority ............


(not applicable for application for IEC)

5. Please tick the appropriate column.

(1) Manufacturer Exporter [ ]


(2) Merchant Exporter [ ]
(3) Service provider [ ]
(4) Merchant cum Manufacturer [ ]
(5) Trust [ ]
(6) Others (please specify) .......................................

6. Status Code
(Please see S.No.7(b) of Appendix-1 of general instructions)

Relevant Certificate No. ..................................


Issuing Date: ........................
Valid upto: ..........................

App.1
7. Category of manufacturing Number Date Issuing
licence authority

SSI Registration

Industrial licence/ IEM

Others (specify)

1. Nature of the concern : [ ]


(Please see S.No.7(c) of Appendix-1 of general instructions)

9. Details of the main Banker Name of the Bank ..............


and Bank Account Account No. ...................
Type of Account ...............
Address........................
...............................

10. RCMC No. .................... Date of Issue ...................


Valid upto ................... Issuing Authority ...............

11. Details of Proprietor/Partner(s)/Director(s)/Karta to be given


in the following manner:

(a) Name ......................................


(b) Father's Name ......................................
(c) Residential address ......................................
(d) E. Mail address ......................................
(e) Telephone ......................................

(NOTE: Attach extra sheet wherever required)

Place: ....... Signature of the Proprietor/Partner(s)/

Director(s)/Karta .........................

Date:......... Name .........................

Designation .........................

App.2

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