APPENDIX - 3 -----------------------------



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APPENDIX - 3 ----------------------------- APPLICATION FORM FOR ALLOTMENT OF IMPORTER-EXPORTER CODE (IEC) NUMBER AND MODIFICATION IN PARTICULARS OF AN EXISTING IEC NO. HOLDER ------------------------------------------------------------------------------- Note: 1. Please see paragraph 2.12 of the Policy and Paragraph 2.9 of this Handbook. 2. Please read the general instructions given at Appendix 1 before filling this application. 3. In addition to this application form (in duplicate) also submit Appendix-2 (in duplicate) alongwith this application. ------------------------------------------------------------------------------ (FOR OFFICE USE ONLY) File Number: Date: IEC No. allotted: ------------------------------------------------------------------------------ 1. Application for (please tick) (A) Allotment of IEC No. (B) Modification in particulars : : of existing IEC No.holder 2. Name and address of the applicant :. (Registered Office in case of limited companies, :. and Head Office :. for others ) PIN [][][][][][] 3. Address of all the Branches/ Divisions/ Units/ factories located in India and abroad. 1.... 3.... PIN [][][][][][] PIN [][][][][][] 2.... 4.... PIN [][][][][][] PIN [][][][][][] 4. In case the application is for modification in existing IEC, give: a) Existing IEC No. :... b) Nature of modification required and details thereof :...... (In case the application is for modification, information in S.No.2 and 3 above will be as per pre.modified status) 5. Particulars of Fees Paid: (i) Bank Receipt/Demand Draft No. :... (ii) Amount(in Rs.) :...

(In.figures) (in words :... (iii) Name of Bank & Branch of Issue :... 6. Permanent Account Number (PAN) :... Issuing authority :... DECLARATION/UNDERTAKING 1. I/We hereby declare that the particulars and the statements made in this application are true and correct to the best of my /our knowledge and belief and nothing has been concealed or held therefrom. 2. I/We full understand that any information furnished in the application if proved incorrect or false will render me/us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. 3. I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, the Rules and Orders framed thereunder, the Export and Import Policy and the Handbook of Procedures. 4. I/We hereby declare that this application is made by me/us in the name of Registered/Head office and I/we have not obtained or applied for Importer Exporter Code Number previously in this name from any office of the DGFT/Development Commissioner (Not applicable for existing IEC number holder). 5. I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the Policy. 6. I/we hereby certify that none of the Proprietor/ Partner(s)/ Director(s)/Karta of the firm or company is a Proprietor/ Partner(s)/ Director(s)/Karta of the firm/company, which has come to the adverse notice of DGFT. Place: Date : Name:... Photo of Designation:....= Official Address:... the Tele.No.:... applicant R Residential Address:... attested by... 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. Certificate from the Banker of the applicant firm (as per Annexure-1 to this form) 3. Two Copies of Pass Port size photographs of the applicant duly attested by the banker of the applicant. 4. A copy of Permanent Account Number issued by Income Tax Authorities, duly attested by the applicant. 5. If there is any non.resident interest in the firm/company and non resident investment is to be made with repatriation benefits, full particulars thereof with photo copy of RBI approval must be submitted. Investment without repatriation benefits, a simple declaration indicating whether it is held with the general/ specific permission of RBI on the letter head of the firm should be furnished. In case of specific approval, a copy may also be furnished. Indian Companies issuing shares to foreign nationals/ NRIs under automatic route,100% scheme or 24/40% schemes are not required to obtain prior approval of RBI. 6. The applicant firm/company should also submit a simple declaration as under:- The (proprietor/ partner(s)/ director(s) as the case may be) of the firm/ company is/ are not associated as proprietor/ partner(s) or director(s) in any other firm/company which is in the caution list of RBI. Note: Where the applicant declares that they are associated with firms/companies caution listed by RBI they will be allotted IE Code No. but with an additional condition that they can export only with RBI's prior approval and they should approach RBI for the purpose.

ANNEXURE.1 TO APPENDIX.3 ----------------------------- BANK'S CERTIFICATE (To be issued on the official letter head of the Bank) Ref No.... To............ (Name and address of the licensing authority) Sir/ Madam, We certify that M/s... (Name and Address of the applicant) are maintaining a Savings Bank Account / Current Account (tick whichever is applicable) No.... with us since... (Signature of the Banker) Name... Designation... Date:... Place:... (Official Stamp)

APPENDIX - 3A --------------------------------- FORMAT OF IMPORTER - EXPORTER CODE NUMBER ----------------------------------------------------------------------------------------------------------- GOVERNMENT OF INDIA MINISTRY OF COMMERCE & INDUSTRY O/O JT./DY.DIRECTOR GENERAL OF FOREIGN TRADE -------------------------------- -------------------------------- (Full Address) CERTIFICATE OF IMPORTER - EXPORTER CODE (IEC) NUMBER ---------------------------------------------------- 1. Name 2. Address 3. Address of the Branches/Division/. Units/factories, if any.. PIN [][][][][][] 4. IEC Number PIN [][][][][][] 5. Date of issue 6. PAN Number (Signature of the Issuing Authority) Name Designation Place... Date... (Official Stamp) (Issued from File No.... ) Note: In case of any change in the name/address or constitution of IEC holder, the IEC holder shall cease to be eligible to import or export against the IEC number after expiry of 60 days from the date of such change unless in the meantime, the consequential changes are effected in the IEC by the concerned licensing authority.

APPENDIX- 3B ------------------------------ STATEMENT OF PARTICULARS OF IEC NUMBERS ISSUED FOR THE PERIOD Please see Paragraph 2.9.1 of the Handbook. Sr.No. Name Address IEC No. Date of Allotment [1] [2] [3] [4] [5] Note: The periodicity of the submission of the above information by the IEC issuing authorities shall be on fortnightly basis and the information shall be submitted to the concerned office of RBI by the end of the week succeeding the fortnight.