APPENDIX - 2

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PROFILE OF EXPORTER/ IMPORTER

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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.

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1.	Name of the applicant	:...................................
2.	Address of the applicant (Registered Office in case of limited companies, and Head Office for others for others)	:................................... :................................... :................................... :................................... Tele No.:........................... Fax No :........................... E.Mail address: ....................
3.	Date of establishment of business/factory in India	cccccccc  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: ..........................

7.	Category of manufacturing licence	Number	Date	Issuing authority
	SSI Registration
	Industrial licence/ IEM
	Others (specify)
8.	Nature of the concern    :    [     ] (Please see S.No.7(c) of Appendix-1 of general instructions)
9.	Details of the main Banker and Bank Account		Name of the Bank .............. 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/Trustee	...................................................
Date:.........	Name	...................................................
	Designation	...................................................

(Please refer PN. No. 58/2004, DT. 07/03/2005 related to S.No. 39 & 40 above)

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