APPENDIX -2R
Format of Registration-cum-Membership Certificate

PART I
(To be filled in by the applicant)

1 Name of the exporter : M/s________________________________________________________________________________

2 IEC Number : _____________________________

3 . Address of the Registered/Head Office ________________________________________________________

4 Date of establishment : ____________________________

5 . Description of goods/ services for which registered : ________________________________________________________

6 . Registration Number :

7. Registered as :                                         a) Manufacturer exporter
                                                                   b) Merchant exporter
                                                                   c) Merchant cum manufacturer exporter____________________

8 . Name of the Proprietor/ Partner(s)/ Director(s)/Karta : ____________________________

This certificate is issued as per the details of our records and is subject to the conditions laid down in the relevant scheme of registration of this council.

(Signature of the competent
officer of the E.P. Council)

Name _________________

Designation _________________

Seal ________________

Valid/renewed upto _______________ Date of issue _________________

Note: This import certificate is not a substitute for import Licence in respect of the items mentioned restricted under ITC(HS) and an import licence, in addition to this Certificate, will have to obtained wherever required for such items.