Customs Forms
1FORM-A
[See Regulation 5(1)]
To
The Commissioner of Customs,
(Details of jurisdiction)
Subject : Application Form for Grant of Custom House Agents Licence under
Section 146 of the Customs Act, 1962
Sir/Madam,
In response to the Public Notice No ………………dated
………………I/We undersigned hereby submit the following details for Grant
of Custom House Agents Licence under Section 146 of the Customs Act, 1962 :
1. Name of the applicant, (in case the applicant is a firm or a company, the
names of each of the partners of the firm or the directors of the company, as
the case may be):—
2. Full address of the applicant, (in case, the applicant is a firm or a
company, the address of each of the partners of the firm or the directors of the
company, as the case may be):—
3. In case the applicant is a firm or a company, the name(s) of its
partner/partners or director/directors or duly authorized employees who will
actually be engaged in the work, as Customs House Agents.
4. In case it is desired to appoint clerk(s), the name and address of the
clerk(s):—
5. Educational Qualification of each of the persons, who will actually be
engaged in the work as Customs House Agent (including proof of working knowledge
of computers) :—
6. Particulars regarding knowledge of English, local language and Hindi (these
particulars are required in respect of each of the persons actually engaged in
the work as Customs House Agent).
7. Particulars regarding knowledge of Customs Law and procedure. (These
Particulars are required in respect of each of the persons actually engaged in
the work as Customs House Agent.
8. Whether the applicant had earlier applied for a licence to act as Customs
House Agent and whether such application was rejected.
9. Whether he or the firm or company by whom he is employed have earlier held a
Customs House Agent’s Licence under these Regulations and whether it was
cancelled or suspended.
10. Whether the applicant or any of the person proposed to be employed by him
have been penalized, convicted or prosecuted under any of the provisions of the
Customs Act, 1962 (52 of 1962) or any other law for the time being in force :-
11. Number and date of each of the documents furnished in accordance with
Regulation 5.
I/We hereby affirm that I/We have read the Customs House Agent’s Licensing
Regulations, 2004. and agree to abide by them.
Date :
Signature
of applicant(s)
1.
Substituted vide Notification No. 77/2007-Cus (NT)
Dated 27/7/2007