APPENDIX 20A

FORM OF APPLICATION OF IDENTITY CARD

1) Name of the person (in whose favour Identity Card is to be issued)	:.............................	Photograph duly attested by Proprietor/ Partner/ Director/Power of Attorney Holder
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) /Licence(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/Power of Attorney Holder 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.