Appendix 20 A

Form of Application of Identity Card

Photograph duly Proprietor/
Partner/
Director attested by

1) Name of the person : .............................

(in whose favour Identity

Card is to be issued)

2) Designation of the person : .............................

3) IEC Number : .............................

4) Details of Fee :

Bank receipt/ ..............

DD No.& date

Amount Rs. ...

Name of the Bank

Branch of issue

Declaration

i) I am the Proprietor/Partner/Director of the firm/company.

ii) I hereby declare that Shri .................... in whose favour identity card is to be issued is the authorised employee of the firm.

iii) I further undertake that the document(s) /Licence(s) may be handed over to the Identity Card holder at the sole risk and responsibility of the firm.

Signature of the proprietor/ partner/ director

Name

Designation

Official Address

Tele.No

Residential Address:

E.Mail Address

Place

Date

Documents to be enclosed with the application form

1. Bank Receipt (in duplicate)/Demand Draft evidencing payment of application fee in terms of Appendix-29.

2. Two passport size photographs of the person in whose favour identity card is to be issued.