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ANF 2 A

Application Form for Issue / Modification in Importer ExporterCode Number (IEC)

Part A

To be filled b t!e Issuin" Aut!orit

IEC #etails$$

i. IEC Number

ii. Date of Issue

iii. Issuing Authority

To be filled b t!e applicants

Note% Please state &Not Applicable' !ereer t!e information / data is not applicable to ou*Fields mar+ed , are optional* All ot!ers are mandator-* Applicant Firm #etails

i. Name

ii. Address(Registered Office in case of Companies andHead Office in case of Others)

iii. Address of a !ranches " Di#isions " $nits " %actoriesocated in India & abroad (attach e'tra sheet if reuired)

i#. eephone*

#. Emai address (for correspondence +ith D,%)*

2* #etails of Proprietor / Partners / #irectors / .arta / Trusteeof t!e applicant firm (attac! extra s!eet if reuired)

ota Number of -artners " Directors " arta " rusteein the appicant firm

Folloin" information ma be proided for eac! Proprietor / Partners / #irectors / .arta / Trusteeof t!e applicant firmi. Name

ii. %ather/s Name

iii. Residentia Address

Un-attested

Photograph of the

applicant.

Identical

photograph should

be used on the

Bank Certificate.

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i#. eephone

0* Nature of Concern (please tic+) ( 1 )

i. ,o#ernment $nderta0ing ii. -ubic 1imited Company

iii. -ri#ate 1imited Company

i#. -roprietorship

#. -artnership

#i. Others

* Tpe of Exporter (please tic+) ( 1 )

i. 2erchant E'porter ii. 2anufacturer E'porter iii. 3er#ice -ro#ider i#. Others (pease specify) #. 2erchant cum 2anufacturer

3* 4an+ Account #etails

i. Name of the !an0

ii. Address of the !an0

iii. ype of !an0 Account

i#. !an0 Account Number

#. 4ear of opening !an0 Account

5* PAN #etails

i. -AN Number

ii. Issuing Authority

6* Application Fee #etails

Amount (Rs)5Rupees

Demand Draft

Date of Issue

Name of the !an0 and its !ranch on +hich dra+n

3ignature of the Appicant -ace

Name Date

Designation

Officia Addresseephone

Residentia Address

Emai Address

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Part 4

APPEN#I7 -6 A

F89MAT 8F 4AN. CE9TIFICATE F89 I::;E 8F IEC

(o be issued on the officia etter head of the !an0)

666666666666666666666666666666666666666666666666666666666666666666666666666666

Ref No. ...........................

o

..........................................

.......................................... ..........................................

(Name and address of the icensing authority)

3ir" 2adam7

8e certify that 2"s...................................................................... (Name and Address of the appicant) aremaintaining a 3a#ings !an0 Account " Current Account (tic0 +hiche#er is appicabe) No. ........................ +ith ussince ..................

.........................................

Affi'

-assport3i9e-hotograph of theappicant

Note: he !an0er must identify and attest the photograph.

(3ignature of the !an0er)

Name ...............................Designation ;;;;;;

Date: ...................-ace: ................... (Banks

Stamp)

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Part C

%or 2odification of Import E'port Code Number

IEC Number