Eximkey India DGFT, Customs, Excise, Export Import policy, Foreign Trade Policy and export import data.

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 _______________

PART - II

(TO BE FILLED IN BY THE REGISTERING AUTHORITY)

(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)
Name	______________
Designation	______________
Seal	_____________

Valid/renewed upto _________________________ Date of issue ___________________________
Space for endorsement of any amendments in this certificate

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