Customs Brokers Licensing Regulation 2018

FORM - F
[see sub-regulation (2) of regulation 13]

Identity Card

Customs Broker Licence No. ………

Identity Card               

M/s./Shri/Ms.:
Designation (Proprietor, Partner, Director, Employee) :
Permanent Account Number (PAN):
Aadhaar Number:
Issued at :
Valid up to :
Name of the Customs Broker :
Type of Customs Broker:
(Proprietorship/Firm/Pvt./ Public Ltd./Others)

Specimen signature of the Customs Broker:

I………………….. have passed the examination conducted under regulation 6 of the Customs Brokers Licensing Regulations, 2018.

Signature of the Deputy/
Assistant Commissioner of Customs
(With seal)

(Photo to be supplied by the Customs Broker)