APPENDIX 19B - FORMAT OF REGISTRATION-CUM-MEMBERSHIP CERTIFICATE - Foreign Trade Procedure (RE - 2012) / 2009-14 (From 5-6-2012 to 31-3-2015)

APPENDIX 19 B 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 _________________ Space for endorsement of any amendments in this certificate