ANF 2C
 APPLICATION FORM FOR REGISTRATION CUM MEMBERSHIP CERTIFICATE (RCMC)

To

The______________________
     ______________________
     ______________________
(Name and Address of the Council)

Dear Sir,

Kindly register us as Merchant exporter /Manufacturer exporter/Merchant cum Manufacturer exporter of the export product(s) mentioned below.

1. Name of the applicant            : _________________________
2. (i) Address of the applicant. (Registered Office in case of limited companies, and the head office for others) :  ________________________________
(ii) Name address of the branches, if any : _______________________________      
(iii) Name and address of the factory : _______________________________

3.

 (i)
(ii)
(iii) 		IEC number
Date of issue
Issuing authority		 : ___________________________________________________________________________________________
___________

4.

  Payment details :  

5a.

 If registration is required as a manufacturer exporter Date (SSI Registration/ Industrial Licence/IEM ) : No. ________________
Date_______________________
Issuing Authority______________________

b.

 Others (specify) :  

c.

EH/TH/STH/SSTH/SHE/ISEH/ISSEH /ISSEH certificate number

 : Valid upto______________________

6.

 If Status Holder : (category) : certificate number:_______________________
Valid upto______________

7.

 (a)

Name of export product(s) or its category for which registration is required

 : ________________________
  (b) Main line of business of applicant :  

8.

 I hereby solemnly declare that the above stated information is true and correct and I undertake to abide by the FT (D&R) Act, 1992 and the provisions under FTP.

9.

I/We hereby solemnly declare that the above stated information is true and correct. I/We undertake, without any reservation, to:
(a) abide by the terms of the registration certificate granted to us on all our exports;
(b) agree to abide by any code of conduct that may be prescribed;
(c) agree to abide by export floor price condition that may be stipulated by the Registering Authority

10.

We further understand that our registration is liable to be cancelled in the event of breach of any of the undertakings mentioned above.

11.

I solemnly declare that I have applied to the Export Promotion Council which pertains to our main line of business. In case I have applied to any other council, the application has been made within the purview of the provisions of Para 2.94 of the Handbook of Procedures.

Place_______
Date_______

Yours faithfully,

(Signature)

Name _______________
Address _______________
Designation  _______________
Email _______________
Mobile no. _______________
 

Documents to be enclosed with the application form:
1. A self certified copy of the IEC issued by the licensing authority concerned.