Customs Brokers Licensing Regulation 2018
FORM - A
[see sub-regulation (2) of
regulation 4]
Application Form for Grant of Customs Broker’s License under section 146 of the Customs Act, 1962
| 1. | Name of the applicant :- |
| 2. | Full address of the applicant :- |
| 3. | Aadhaar Number:- |
| 4. | Names, Permanent Account Numbers (PAN) and address of each of the partners of the firm or the directors of the company, as the case may be, in case the applicant is a firm or a company :- |
| 5. | Name and Permanent Account Numbers (PAN) of its partner/partners or director/directors who will actually be engaged in the work as Customs Broker, in case the applicant is a firm or a company:- |
| 6. | Educational qualification of each of the persons, who may be engaged as Customs Broker :- |
| 7. | Total number of attempts the applicant has made in the examination referred to in regulation 9 of the Custom House Agents Licensing Regulation, 1984 or regulation 8 of the Custom House Agents Licensing Regulation, 2004 or regulation 6 of the Customs Brokers Licensing Regulations, 2013 or regulation 6 of the Customs Brokers Licensing Regulations, 2018:- |
| Declaration : | |
| (a) | I have working knowledge of English/local language (………)/Hindi |
| (b) | I have not earlier applied for a license to act as Customs Broker and no such application was rejected/accepted |
| (c) | The firm or company by whom the undersigned is employed have earlier held a Customs House Agent or Customs Broker’s License under the Customs House Licensing Regulation, 1984, the Customs House Licensing Regulation, 2004 or the Customs House Licensing Regulation, 2013or these regulations and it was cancelled or suspended/not cancelled or suspended. |
| (d) | The undersigned/the person proposed to be employed by me have been/have not been penalised, convicted or prosecuted under any of the provisions of the Customs Act, 1962 (52 of 1962), the Central Excise Act, 1944 (1 of 1944), and the Finance Act, 1994, the Central Goods and Services Act, 2017 (12 of 2017) and Integrated Goods and Services Tax Act, 2017 (13 of 2017). |
List of documents furnished in accordance with regulation 6 of Customs Brokers
Licensing Regulations, 2018
| S. No. | Educational | Financial |
| 1. | ||
| 2. | ||
| 3. | ||
| 4. |
I/We hereby affirm that I/we have read the Customs Brokers Licensing Regulations, 2018 and agree to abide by them.
Date :
Signature of applicant