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PSC Application Form

This document is an application form for exporters to apply for phytosanitary certification of plants and plant products from the Department of Agriculture in Karnataka, India. The form requests information about the exporter, importer, commodity being exported including name, quantity, packaging, origin and destination. It also asks for documentation like import permits, export licenses, invoices. The exporter must declare that the information provided is true and must agree to follow instructions regarding inspection, treatment and certification. Upon submission, the duplicate copy will be returned with quarantine orders and receipt of payment.

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debeesantosh
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
55 views

PSC Application Form

This document is an application form for exporters to apply for phytosanitary certification of plants and plant products from the Department of Agriculture in Karnataka, India. The form requests information about the exporter, importer, commodity being exported including name, quantity, packaging, origin and destination. It also asks for documentation like import permits, export licenses, invoices. The exporter must declare that the information provided is true and must agree to follow instructions regarding inspection, treatment and certification. Upon submission, the duplicate copy will be returned with quarantine orders and receipt of payment.

Uploaded by

debeesantosh
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FOR EXPORT AND PHYTOSANITARY CERTIFICATION OF PLANTS/PLANT PRODUCTS

AND OTHER REGULATED ARTICLES.


To For PQ Office Use :
The Dy. Director of Agriculture
Plant Pathology) Dept of Agriculture, Receipt No. : Registration No. :
Govt. of Karnataka, Sheshadri Road, Date of Receipt : Date of Registration:
Bangalore

I/We, the exporter/the authorized agent of the exporter, herewith submit an application for inspection / disinfections
/disinfestations and issue of Phytosanitary Certificate for export of the goods described hereunder:

Name & address of the Exporter : Name & address of Importer: For PQ Office Use

Export Status:
Prohibited
Restricted
Canalised
Commodity Name (Common/Botanical Quantity ( Wt./Vol): Unrestricted
name)/HS Code:
Documents verified:
Import Permit
Export License
No. of pieces / Packages/Container particulars: Distinguishing marks: Letter of Credit/
Contract/ Agreement
Invoice
Fumigation Certificate
Nature of packing material: Means of conveyance: Shipping /Airway Bill
Others
_______________
(specify)
Country of origin: Port of loading:
Country to which exported: Foreign Port: NB: Tick out appropriate
entry
Date & Place of inspection of goods: Invoice/Shipping/Airway Bill No.& date
Date:

Value of commodity (Rs.): Purpose for Export:


____________
Propagation/Consumption
*Sign. of staff
(N.B: Strike out, which is not applicable).

Declaration

(1) I/We the exporter / the authorized agent of the exporter, on behalf of M/s ------------------------------------------------------------------
-declare that the information furnished on this form, to the best of knowledge and belief is true, correct and complete in every
respect.
(2) I/We shall pay any fees prescribed for inspection/fumigation/treatment of the consignment and any other charges towards issue
of Phytosanitary/fumigation/treatment certificate.
(3) I/We shall carry out the instructions given by the Plant Protection Adviser to the Govt. of India or any Officer duly authorized by
him in this behalf in connection with inspection/fumigation/treatment of the consignment and issue of Phytosanitary Certificate.
(4) I/We shall provide any relevant information and related documents connected with export of consignment and issue of
Phytosanitary Certificate.

Date : Seal
___________________________
( )

*Sign. of Exporter/Authorised Agent


N.B 1.Application should be submitted by the Exporter/his authorised agent in duplicate duly filled and complete.
2.Duplicate copy to be returned to the exporter/his authorised agent after endorsing the quarantine order and receipt of payment.
These conditions will not be applicable for on-line registration.

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