APPENDIX 05A - APPLICATION FOR RECOGNITION AS PRE-SHIPMENT INSPECTION AGENCY FOR METAL SCRAP - Foreign Trade Procedure (RE - 2012) / 2009-14 (From 5-6-2012 to 31-3-2015)

1 [APPENDIX 5-A APPLICATION FOR RECOGNITION AS PRE-SHIPMENT INSPECTION AGENCY FOR METAL SCRAP (Refer Para 2.32.2 A of HBP vol.1) 1.1 Name of the Agency 1.2 Address 1.3 Details of application fee paid D.D./Bank Receipt No.________ Date _________ Amount ___________ Name of Bank and its Branch on which draw 2. Mandatory Testing equipments/Machinery for testing metal scrap: Table 2.1 S No Description of Equipment Make and Model No. Nos. i Hand held Radiation Survey Meters ii Radio Nuclear Identifier iii Explosives Detection System having ability to detect Liquid / Plastic / Powder / Particles / Solid / Metallic and Non-Metallic Scrap / Waste Attach additional information, if required, on separate paper 2.2 List out any other equipment(s) available including laboratory facilities Table 2.2 S No Equipment / Laboratory Facility Capability Nos i ii iii 3. Membership: S No Name of the Organisation Member since i International Federation of Inspection Agencies (IFIA), London ii Institute of Scrap Recycling Industries (ISRI) Washington DC iii Bureau of International Recycling, Belgium iv Metal Recycling Association of India Please attach a copy of such document to show membership. 4 Experience in metal inspection: Quantity of metal scrap inspected (in MTs) in the last five years/ destination country-wise Table 4.1 For Ferrous scrap S No Exporting Country Destination Country Quantity of Ferrous Scrap inspected in preceding Years Year 5 Year 4 Year 3 Year 2 Year 1 Total i ii iii iv Grand Total Table 4.2 For Non Ferrous scrap S.No Exporting Country Destination Country Quantity of Non-Ferrous Scrap inspected in preceding Years Year 5 Year 4 Year 3 Year 2 Year 1 Total i ii iii iv Grand Total 5. Attach copy of last Annual Report/balance sheet of the Company. 6. Intended Area of Operations for issuance of certificate 1. Address of Head Office. __________________________________ 2. Address(es) of Branch Offices __________________________________ (from where the Inspection would be carried out) __________________________________ (a) The area of operation of PSIA would be as per the territory location of the agency and the Agency is required to declare all its office addresses coming in the area of its jurisdiction. (b) The Agency shall be authorised to issue the certificate for the country in which it is located and not for any country in which it is not physically present. (c) In addition to the territory / location of the inspection agency, the jurisdiction would also cover those countries in which the Inspection Agency has its branch offices. 7. Manpower: Details of Inspecting persons / inspectors who would carry out inspection: T he minimum qualification of the Inspecting officer should not be less than 10 + 2 / Senior High School with Science (physics and Chemistry). S No Names of Technical person(s) Address Nationality Phone No. E Mail Address Qualification Experience in inspection of metal scrap 7.1 Whether you have been debarred /de-listed by Indian Government or other Governments for carrying out inspection activities. If yes, details thereof. --------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------- 7.2 Whether any judicial / quasi-judicial proceedings are pending against you in any country / legal authority. If yes, details thereof. --------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------- Declaration (1) I / We hereby declare that the particulars and the statements made in this application are true and correct to the best of my/our knowledge and belief and nothing has been concealed or held there from. (2) I/We fully understand that any information furnished in the application if found incorrect or false will render me / us liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. (3) I/We hereby undertake that the in case it is found that the consignment is not scrap or prohibited items are present in it, I would be liable to pay a penalty of ₹ 10 lakhs, (if based in India) or US$20,000 (if based in foreign country), in addition to suspension / cancellation of recognition certificate. (4) I/We undertake to abide by the provisions of the FT (D R) Act, 1992, the Rules and Orders framed there under, FTP, HBP v 1 and HBP v2 and ITC (HS). (5) I/We hereby certify that none of the Proprietor / Partner(s) / Director(s) / Karta / Trustee of firm / company, as the case may be, is/are a Proprietor/Partner(s)/ Director(s)/Karta/Trustee in any other firm/Company which has come to adverse notice of DGFT. (6) I/We hereby certify that the Proprietor / Partner(s) / Director(s) / Karta / Trustee, as the case may be, of the firm/company is / are not associated as Proprietor / Partner(s) / Director(s) / Karta / Trustee in any other firm / company which is in the caution list of Reserve Bank of India. (7) I hereby certify that I am authorised to verify and sign this declaration as per Paragraph 9.9 of the Foreign Trade Policy. Signature of the Applicant Name Designation Official Address Telephone Residential Address Email Address Place Date SEAL ] ---------------------------------------- Notes:- 1. Substituted vide Public Notice No.104 (RE-2010)/2009-2014, Dated 23/03/2012