FORM - I - Application Form for registration / renewal of authorised courier [See regulation 7(1)] - Courier Imports and Exports (Electronic Declaration and Processing) Regulations, 2010

FORM - I [See regulation 7(1)] To The 1 [Principal Commissioner of Customs or Commissioner of Customs, as the case may be], . (Address) Subject: Application Form for registration / renewal of authorised courier under the Courier Imports and Exports (Electronic Declaration and Processing) Regulations, 2010 issued under Section 157 of the Customs Act, 1962 (52 of 1962). *** Sir / Madam, I/we, the undersigned hereby submit the following details for registration as an authorised courier under the Courier Imports and Exports (Electronic Declaration and processing) Regulations, 2010: This application is for (i) New registration (ii) For new PAN based Registration No. for existing registrants. (iii) Amendment to information pertaining to existing registrants. (1) Name of the Authorized Courier: (2) Name of Customs House where registration is required: (3) Existing Authorized Courier Registration No.(s), date Customs Airport, if any: (4) Permanent Account No. (PAN No.): (5) Constitution of Business: (Specify whether Proprietorship, Partnership, Public Ltd. / Private Ltd. Company Others.) (6) Registered Office address: (Complete details of the following to be provided: Flat /Building/Plot No., Name of premises / Building, Road / Street Name, Locality, City, State, Pin code No., Telephone Nos., Fax No., Email Address) (7) Name and Residential Address of the Proprietor, Partners of the partnership firm, of Directors of the Company or the persons in charge in case of other category, as the case may be: (Complete details of the following to be provided: Flat /Building/Plot No., Name of premises / Building, Road / Street Name, Locality, City, State, Pin code No., Telephone Nos., Fax No., Email Address). (8) Name, designation, residential address and educational qualification / knowledge of Customs law procedure of duly authorized signatory and employees who will actually be engaged in work of Authorized courier: (Complete details of the following to be provided: Flat /Building/Plot No., Name of premises / Building, Road / Street Name, Locality, City, State, Pin code No., Telephone Nos., Fax No., Email Address) (9) In case, it is desired to appoint employees, Name, designation residential address and educational qualification / knowledge of Customs law procedure of the employees, as the case may be: (Complete details of the following to be provided: Flat /Building/Plot No., Name of premises / Building, Road / Street Name, Locality, City, State, Pin code No., Telephone Nos., Fax No., Email Address) (10) Particulars of the No. of consignments, value of cargo cleared and duty paid as Authorized Courier during last three financial years: (11) Details of Bank Accounts used for business transaction by the Registrant: (Bank Account No., Name of Bank, Name of the Branch address to be provided.) (12) Details of Service Tax Registration: (Service Tax Registration No., date of Issue, Commissionerate, Division, Range). (13) Whether the registration as Authorized Courier held under these Regulations was cancelled or suspended: (14) Whether the applicant or any of the persons 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: (15) Declaration: I am / we are authorized to make the following declarations: I / We declare that all particulars given herein are true and correct. I / We hereby affirm that I/we have read the Courier Imports and Exports (Electronic Declaration and Processing) Regulations, 2010 and agree to abide by them. I / We hereby undertake to intimate any change in respect of the information provided in the aforesaid application within a period of 30 days. Date: Signature and name of the applicant(s) or authorised signatory Place: *** ---------------- Notes:- 1. Substituted vide Not. 56/2014 - Dated 6-8-2014