APPENDIX 20A

FORM OF APPLICATION OF IDENTITY CARD

Photograph duly attested by Proprietor/ Partner/ Director

1) Name of the person (in whose favour Identity Card is to be issued)	:.............................
2) Designation of the person	:.............................
3) IEC Number	:.............................
4) Details of Fee Bank receipt/ .............. DD No.& date Amount Rs. ... Name of the Bank Branch of issue	:.............................

DECLARATION

i) I am the Proprietor/Partner/Director of the firm/company.

ii) I hereby declare that Shri .................... in whose favour identity card is to be issued is the authorised employee of the firm.

iii) I further undertake that the document(s) /Licences/Authorisation(s) may be handed over to the Identity Card holder at the sole risk and responsibility of the firm.

Signature of the proprietor/ partner/ director
Name_______________________________
Designation__________________________
Official Address_______________________
Tele.No_____________________________
Residential Address:___________________
____________________________________
E.Mail Address________________________

Place
Date

Documents to be enclosed with the application form

1. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-29.

2. Two passport size photographs of the person in whose favour identity card is to be issued.

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