1. IEC Number
2. Applicant Details
i. Name
ii. Address
3. RCMC Details
i. RCMC Number
ii. Date of Issue
iii. Issuing Authority
iv. Valid upto
Product(s) for which registered
4. Type of Exporter (please tick) ( &＃61654; )
i. Merchant Exporter
ii. Manufacturer Exporter
iii. Service Provider
iv. Others (please specify)
v. Merchant cum Manufacturer
5. Application Fee Details
Amount (Rs)
Demand Draft/Bank Receipt/Electronic Fund Transfer No
Date of Issue
Name of the Bank on which drawn
Bank Branch on which drawn
6. FOB Value of exports (inclusive of commission)
i. In Rupees
ii. In freely convertible currency
7. DEPB Claimed
i. In Rupees (in words)
ii . In Rupees (in figures)
8. Port of Registration (for the purpose of imports):
9. Details of export made: