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Procedure

APPENDIX 5

Document type
Procedure
Dated

FORM OF APPLICATION OF IDENTITY CARD

APPENDIX - 5


FORM OF APPLICATION OF IDENTITY CARD
Note: Please see paragraph 2.16 of this Handbook
FOR OFFICE USE


File No.: ................................ Date: .........
...........................................................
Photograph duly
attested by
Proprietor/
Partner /
Director




 1) 	Name of the person                				:........................................ 
       	(in whose favour Identity Card is
       	to be issued) 

 2) 	Designation of the person  					:........................................

 3) 	Residential address                 				:........................................
                                         					.........................................
 4) 	Name and address of the 
    	applicant firm                    					:........................................
                                         					.........................................
 5) 	IEC Number                        				:........................................

 6) 	Details of Fee                    					:
                                       					  Bank receipt / ...................
                                       					  DD No.& date 
                                       					  Amount Rs. ....................... 
                                       					  Name of the Bank and
                                       					  Branch of issue ........................

DECLARATION
  1. I am the Proprietor / Partner / Director of the firm/company.

  2. I hereby declare that Shri.................... in whose favour identity card is to be issued is the authorised employee of the firm.

  3. 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

Name: .................
Designation: .................
Official Address: .................
.................
Tele.No.: ..................
Residential Address: .................


Place :                                             						       ................
Date  :                            						        E. Mail address: ...................

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.

  3. Copy of RCMC duly attested by Proprietor /Partner  / Director.

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