APPENDIX - 56
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			APPLICATION FORM FOR ISSUANCE OF GREEN CARD
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 				FOR OFFICIAL USE
                      
File No.:---------------------------               Date:--------------


Note: Please see paragraph 4.23, 14.4 of the  Policy and paragraph 4.35 of the Handbook.
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1.    	Name of the applicant            :...................................

2.    	Address of the   applicant       :...................................
      	(Registered   Office   in        :.................................
      	case of companies,               :...................................
      	and Head Office for              :...................................
      	others )

                                                Tele No.:.....................
                                                Fax  No :.....................
                                                E.Mail No.....................

3.    	IEC No				 :
						Date of Issue ........Issuing Authority ........

4.    	Permanent Account Number (PAN)  of Income Tax    ......................
      	Issuing Authority ......................

5.    	No & Date of SSI Registration/................ Issuing .................
      	Industrial Licence/ IEM  ......................  Authority ............
      	Others (specify)
	OR
6.   	ISO 9000  (Series) or IS/ISO 9000 (Series)or ISO 14000 (Series) or HACCP
     	or WHO-GMP or SEI-CMM level 2 certification No .......... date ..........

7.   	RCMC No. ........................ Date of Issue ...................
   	Valid upto ...................... Issuing Authority ...............

8.	Details of Directors/Partners/Proprietor/Karta to be given in the    following manner:
(a)	Name............................
(b)	Father"s Name............................
(c)	Residential address............................
(d)	E. Mail address	............................
(c)	Telephone............................
                                                 

(Note): Attach extra sheet wherever required)

Place: .......              			Signature  of the Director/Partner
                                      		Proprietor/Karta .................
Date:.........                        	 	Name  .......................
                                           	Designation  ................      


Documents to be enclosed with the application form____________________________


a.	A copy of SSI Registration/ Industrial Licence/IEM and a copy of Chartered Accountant/
	Cost accountant certificate certifying that the applicant has exported more than 50% of
	its production in the preceeding year.
	OR
   	A copy of quality certification as mentioned in column 6.

b.	A certificate from Chartered Accountant /Cost Accountant certifying the FOB value of
	exports in preceeding year in the form given in Appendix-26.

c.	Three copies of photograph duly attested in respect of each person for whom the green
	card is applied. One photograph shall be pasted on the top of the application form
	whereas two copies to be enclosed with the application form.