Port ÝSBÝ Cyprus Free Zone & Marine Logistics Services Ltd.
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1 GAZÝ MAÐUSA SERBEST LÝMAN VE BÖLGESÝ FAALÝYET MÜRACAAT FORMU FAMAGUSTA FREE PORT & ZONE OPERATION APPLICATION FORM Port ÝSBÝ Cyprus Free Zone & Marine Logistics Services Ltd. SERBEST BÖLGE VE LÝMAN ݪLETMESÝ FREE TRADE ZONE & PORT MANAGEMENT Gazi Maðusa Serbest Bölge ve Limaný G.Maðusa - KKTC Famagusta Free Trade Zone & Port Famagusta TRNC Tel: +(90) (Pbx) Fax:+(90) info@portisbi.com 1
2 1-FALÝYET RUHSATI TALEP EDENÝN Operation Applicante TESCÝL EDÝLMESÝ TASARLANAN KURULUªUN Proposed Establishment To be Registred ADI TELEFON : Name : FAKS : ADRESÝ Adress: MAGOSA SERBEST BÖLGESÝ FALÝYETE GEÇME TARÝHÝ Proposed Date Of Operation BÖLGEDE YAPACAÐI FALÝYET Proposed Zone Oprtation SERMAYESÝ ÖDENMݪ SERMAYÝSÝ ORTAK SAYISI Authorised Capital Paid-up Capital Number of Partners USD...USD YERLÝ PAYI Local Partners Share YABANCI PAYI Foreign Partners Share BAªLICA ORTAKLARIN ADLARI UYRUÐU ÖDENMݪ SERMAYE TURAR Name of Main Partner Nationality Paid-up Capital Amount 2
3 (VARSA) KKTC DEKÝ TEMSÝLCÝNÝN ADI (Ýf any) Representatives Name in TRNC. PORT ÝSBÝ CYPRUS FREE ZONE MARÝNE & LOGÝSTÝC SERVÝCE LTD. ADRESÝ Adress MAÐUSA SERBEST BÖLGE VARSA ANA ªÝRKETÝN ADI (If any) Home Company s Name ADRESÝ Adress ANA FALÝYET Main Line Of Business TELEFON PHONE FAKS FAX TELEFON: PHONE FAXS FAX KURULUª YILI SERMAYESÝ ÖDENMݪ SERMAYE Year of Establishment Authorised Capital Paid-up Capital VARSA KENDÝSÝNÝN, ORTAKLARININ KKTC VE/VEYA DÝÐER SERBEST BÖLGE VEYA ÜLKELERDEKÝ FAALÝYETLERÝ (If any) Applicant s and/or Partners Operation in TRNC Or Any Other Free Zones or Countries FALÝYET KONULARI ÜLKE BÖLGE ADI YATIRIM TUTARI(ABD$) Activities Country Name of Zone Investment Amount (US$) 2- YAPMAK ÝSTEDÝÐÝNÝZ BÖLGE FAALÝYETÝ (UYGUN KARELERÝ ÝªARETLEYÝNÝZ) Proposed Zone Operation ( Mark Relevant Boxes) ÜRETÝM Production ALIM, SATIM Purchasing, Selling DEPOLAMA Storing X X X 3
4 AMBALAJLAMA, ETÝKETLEME, MARKALAMA Packing, Labelling, Marking MONTAJ, DEMONTAJ Assembling, Disassembling BAKIM, ONARIM Repair, Maintenance MAKÝNE PARKI Machinery Parking TÝCARÝ VE SINAÝ GÖZETÝM Survey BANKACILIK Banking SÝGORTACILIK Insurance DÝÐERLERÝ ( AªAÐIDA BELÝRTÝNÝZ) Other (Specify Below) 3- TALEP EDÝLEN ALAN Required Area X X X X G G G G ÝNªAATIN TABAN ALANI (M 2 ) Base Area Of the Construction (m 2) 2 TALEP EDÝLEN AÇIK ALAN (M ) 500M2 Reguired Open Areas (M 2 ) ÝNªAATIN KAT SAYISI Number of Floors 1 KAT ÝNªAATIN TÝPÝ SUNDURMA Type Of Construction 4- TALEP EDÝLEN OFÝS VE ݪYERÝ Required Office and Working Place 4
5 TALEP EDÝLEN OFÝS SAYISI Number of Required Office KAPALI AÇIK Closed Open TALEP EDÝLEN ALAN (M ) 2 Required Area (M ) 5- YATIRIM HARCAMALARI (CARÝ YIL FÝYATLARI ÝLE) Investment Expenditures (In Current Years Prices) YAPILACAK ÖDEMELER (ABD $) Payments To Be Made (US $) KKTC YE To TRNC DIªARIYA Abroad BÝNA Construction MAKÝNE, TEÇHÝZAT Machinery and Equipment USD USD ݪ GÜCÜ Manpower DÝÐERLERÝ Others TOPLAM Total USD USD TAHMÝNÝ DÖVÝZ YATIRIM TUTARI 5
6 The Estimated Amount of Foreign Currency to be Invested 6- ORTALAMA YILLIK ݪLETME HARCAMALARI (CARÝ YIL FÝYATLARI ÝLE) Average Annual Operating Expenditures (In Current Year s Prices) YAPILACAK ÖDEMELER (ABD $) Payments To Be Made (US $) KKTC YE To TRNC DIªARIYA Abroad HAMMADDE VE ARA MALLARI Raw and Intermediate Goods ݪGÜCÜ Manpower KREDÝ, ANA PARA VE FAÝZ Credit, Pricipal And Interest GAYRÝ MADDÝ HAKLAR Intangible Rights KÝRA Rent SÝGORTA Insurance DÝÐERLERÝ Others TOPLAM Total 6
7 7- ÝHTÝYAÇLAR Requirements SU 3 Water X M /GÜN 3 M /Day ELEKTRÝK KWA Elektricity X KWA TELEFONLAR ADET Phones Unit TELEKS ADET Telex Unit FAX ADET Fax Unit 8- ORTALAMA YILLIK ÝSTÝHDAM Average Annual Expendiare YÖNETÝCÝ Administrators KKTC UYRUKU Citizen YABANCI Foreign TOPLAM Total BÜRO PERSONELÝ Office Personnel VASIFLI ݪCÝ Quailified Workers 7
8 TOPLAM Total 9- FAALÝYETÝNÝZLE ÝLGÝLÝ ÇEVRE KÝRLÝLÝÐÝNÝ NASIL ÖNLEYECEKSÝNÝZ. AÇIKLAYINIZ. Describe how you intend to prevent Environmental pollution ÇED RAPORU ÇERÇEVESÝNDE FAALÝYET GÖSTERECEKTÝR 10- BÖLGE FAALÝYETÝ VE TAMAMLAYICI ݪLEMLER Zone Operation and complementry Activities ÜRETÝM Production ÜRETÝM METODUNUZU VE/VEYA ݪLEMLERÝNÝ AKIM ªEMASI ÝLE/ AÇIKLAYINIZ (EK 12.2) Describe your production process and/or Methods with a Folwchart (Enc. 12.2) ÜRETÝM LÝSANS ALTINDA MI? (PATENT, MARKA VB) Production Under Licence? (Patent, trademark etc.) 8
9 HAYIR No G EVET G Yes NUMARASI Number LÝSANS ANLAªMASI HAKKINDA KISA BÝLGÝ Brief Description of the Licence Agreement ORTALAMA YILLIK ÜRETÝM Averange Annual Procuntion MÝKTAR Quantity DEÐER Value ÜRETÝLECEK BAªLICA MALLAR Goods to be Produced 9
10 TOPLAM Total ALIM SATIM Purchasing SATIN ALMA Purchasing ORTALAMA YILLIK Annual Averge KKTC DEN From TRNC DIªARDAN 10
11 From Abroad MÝKTAR DEÐER (ABD$ MÝKTAR DEÐER (ABD$ SATIª Selling SATILACAK BAªLICA MALLAR Main Goods To Be Sold ORTALAMA YILLIK Annual Average KKTC YE To TRNC DIªARIYA (ÝHRACAT) Abroad (Export) MÝKTAR Quantity DEÐER (ABD$) Value (US$) MÝKTAR Quantity DEÐER (ABD$) Value (US$) DEPOLAMA 11
12 Storage DEPONUN CÝNSÝ Storage Type AÇIK Open KAPALI Close SOÐUK HAVA Cold Storage DÝÐER (AÇIKLAYINIZ) Other (Specify) DEPOLANACAK BAªLICA MALLAR Main Goods To Be Stored AMBALAJLAMA /ETÝKETLEME/MARKALAMA Packing/Labelling/Marketing AMBALAJLANACAK/ETÝKETLENECEK/MARKALANACAJ MALLAR Goods To Be Packed/Labelled/Marked 12
13 ORTALAMA YILLIK MÝKTAR Annual Average Quantity MONTAJ DEMONTAJ Assembling, Dessasembling MONTAJI, DEMINTAJI YAPILACAK MALLAR Goods To Be Assembled, Disassembled ORTALAMA YILLIK MÝKTAR Annual Averge Quantity BAKIM, ONARIM Repair, Maintenance BAKIM, ONARIM YAPILACAK MALLAR Goods To Be Repaired, Maintained Quantity ORTALAMA YILLIK MÝKTAR Annual Average MAKÝNE PARKI Machiney Parking PARK EDÝLECEK MAKÝNE ORTALAMA YILLIK MÝKTAR EN AÐIR MAKÝNA TONAJI Machinery To Be Parked Annual Average Quantity Weight Of the Heaviest Machine BU FORMADAKÝ VE EKLERÝNDEKÝ MEVCUT DURUMLA ÝLGÝLÝ BÜTÜN BÝLGÝLERÝN DOÐRU OLDUÐUNU VE BU FORMDA BELÝRTTÝÐÝM HUSUSLARI YASA VE TÜZÜK HÜKÜMLERÝNE GÖRE YERÝNE GETÝRECEÐÝMÝ BEYAN EDERÝM VE TAAHHÜT EDERÝM.
14 I hereby Declare And Certify that All Information Given in this form and its Enclosure is Correct and all particulars will be accomplised in compliance with the Law and the provision of the Requlations. ADI TARÝH Name:.. Date (Day7Month/Year) : GÖREVÝ Title :.. YETKÝLÝ ÝMZA Authorised Signature ADRESÝ TELEFONLAR Address: Phones : KÝMLÝK/PASAPORT NO. FAKS Identity/Passport No KKNO: Fax : EKLER Enclosures ÝMZA SAHÝBÝNÝN YETKÝ BELGESÝ, ÝMZA SÝRKÜLERÝ Power Of Attorney of the signatory FÝRMA VE BÖLGEDEKÝ FAALÝYETÝ ÝLE ÝLGÝLÝ TANITICI BÝLGÝ Descriptive Information on the firm and ts Operation in the Zone TAMAMLAYICI BÝLGÝLER Further Information EKLERÝN TOPLAM SAYFA ADEDÝ... Total Number of Enclosed Sheets... 14
15 15
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