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 Indiacccccccc
 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 CertificateNo. ..................................
Issuing Date: ........................
Valid upto: ..........................

7. Category of manufacturing licence NumberDate Issuing authority
  SSI Registration   
 Industrial licence/ IEM   
 Others (specify)   

Nature of the concern
8.:   [ ]

(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 .........................

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

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