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