Appendix-1A

 
 

                                APPENDIX - 1A
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                        PROFILE OF EXPORTER/ IMPORTER
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                              FOR OFFICIAL USE

      File No.:-------------------------------- Date:-----------------

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

                                        --- --- --- --- --- --- --- ---
3.    Date of establishment of         |   |   |   |   |   |   |   |   |
      business/factory in India         --- --- --- --- --- --- --- --- 
                                         d   d   m   m   y   y   y   y


4.    IEC No. ...........Date of Issue ....... Issuing Authority ............


5.    (1) Merchant Exporter(2)Manufacturer Exporter(3)Service provider
      (4) Others(please specify) .....................................

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

8.EH/TH/STH/SSTH/GoldenCertificate No. ......Date ......Valid upto ..........

8(a)  SEH/ISEH/ISSEH/ISSEH         No. ............. Valid upto .............    
      Certificate 




9.Nature of the applicant firm :  .............................

      [1] Government undertaking  [2] Public Limited Company
      [3] Private Limited Company [4] Proprietorship
      [5] Partnership             [6] Others (please specify)


10.    Details of the main Banker    Name of the firm ..............
       and Bank Account              Address........................
 				     Type of Account ...............
                                     Account No. ...................

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

12.    Details  of  Directors/Partners/Proprietor/Karta to be given in 
       the following manner:
                                                                              
   (1)  (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 Director/Partner
                            Proprietor/Karta               .............
Date:.........              Name               .........................
                            Designation         ........................