Express Cargo Clearance System

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COURIER REGISTRATION - FORM I
[see regulation 7(1)]
BUSINESS DETAILS
 
Name of the Authorized Courier:*: Name of ICT where Registration is required:
Existing Authorized Courier Registration Number PAN Number*:
Constitution of Business*: Scanned copy of PAN Number:*:
 
ADDRESS OF REGISTERED OFFICE
 
Flat/Building/Plot Number*: Name of  Premises/Building:*:
Road/Street Name,Locality*: City*:
State*: Pin Code*:
Telephone No:*: Fax:
E-mail:*:  
 
DETAILS OF PROPRIETOR/PARTNER/DIRECTOR
 
Name:*: Designation:*:
Educational Qualification:*: Flat/Building/Plot  No:*:
Name of  Premises/Building:*: Road/Street Name,Locality:*:
City:*: State:*:
Pin Code No:*: Upload Photo of the PROPRIETOR / PARTNER / DIRECTOR:*:
Scanned copy of any ID Proof (Passport, Driving License / Aadhaar card):*: Official Telephone:*:
Residential Telephone: Mobile Number:*:
Fax: E-mail:*:
 
DETAILS OF AUTHORIZED SIGNATORY
 
Name:*: Designation:*:
Educational Qualification:*: Flat/Building/Plot  No:*:
Name of  Premises/Building:*: Road/Street Name,Locality:*:
City:*: State:*:
Pin Code No:*: Upload Photo of the AUTHORISED SIGNATORY:*:
Scanned copy of any ID Proof (Passport, Driving License / Aadhaar card):*: Official Telephone:*:
Residential Telephone: Mobile Number:*:
Fax: E-mail:*:
DETAILS OF EMPLOYEES (APPOINTED ECCS RELATED WORK)
   
Name:*: Designation:*:
Educational Qualification:*: Flat/Building/Plot  No:*:
Name of  Premises/Building:*: Road/Street Name,Locality:*:
City:*: State:*:
Pin Code No:*: Upload Photo of the CLERK:*:
Scanned copy of any ID Proof (Passport, Driving License / Aadhaar card):*: Official Telephone:*:
Residential Telephone: Mobile Number:*:
Fax: E-mail:*:
 
No.of Consignments Cleared during last three financial years:* Value of cargo cleared during last three financial years:*
Duty paid as Authorized Courier during last three financial years:*  
   
DETAILS OF BANK ACCOUNT
   
Bank Account Number*: Name of Bank*:
Name of the Branch*: Branch Address*:
 
GST REGISTRATION DETAILS
 
GSTIN:*: Date of Issue:*:  
Whether the registration as Authorized Courier held under these Regulations was cancelled or suspended:*: YES                          NO
Whether the applicant or any of the persons proposed to be employed by him have been penalized, convicted or prosecuted under any of the provisions of the Customs Act,1962 or any other law for the time being in force:*: YES                          NO
Whether applicant has been convicted in any court of law, or any criminal proceedings are pending before any court of law against the applicant:*: YES                          NO
Certificate issued by a scheduled bank or such other proof for being financially viable:*: Details of Bond:*:
Details of Security:*:
I / We declare that all particulars given herein are true and correct.:*:
I / We hereby affirm that I/we have read the Courier Imports and Exports (Electronic Declaration and Processing) Regulations, 2010 and agree to abide by them:*:
 
UNDERTAKING
 
I/We undertake to: :*:
obtain an authorisation, from each of the consignees or consignors of the imported goods for whom or from whom he has imported such goods; or consignees or consignors of such export goods which he proposes to export, to the effect that he may act as agent of such consignee or consignor, as the case may be, for clearance of such imported or export goods by the proper officer:*:
file electronic declarations, for clearance of imported or export goods, through a person who has passed the examination referred to in regulation 8 or regulation 19 of the Customs House Agents Licensing Regulations, 2004 and who are duly authorisedunder section 146 of the Customs Act, 1962:*:
Advise our consignor or consignee to comply with the provisions of the Act, rules and regulations made thereunder and in case of non-compliance thereof, we shall bring the matter to the notice of the Assistant Commissioner of Customs or Deputy Commissioner of Customs:*:
Verify the antecedent, correctness of Importer Exporter Code (IEC) Number, identity of our clients and the functioning of client in the declared address by using reliable, independent, authentic documents, data or information:*:
Exercise due diligence to ascertain the correctness and completeness of any information which we submit to the proper officer with reference to any work related to the clearance of imported goods or of export goods:*:
Not withhold information communicated to us by an officer of customs, relating to assessment and clearance of imported goods as well as inspection, examination and Clearance of export goods, from a consignor or consignee who is entitled to such information:*:
Not withhold any information relating to assessment and clearance of imported goods or of export goods, from the Assessing Officer:*:
Not attempt to influence the conduct of any officer of Customs in any matter pending before such officer or his subordinates by the use of threat, false accusation, duress or offer of any special inducement or promise of advantage or by the bestowing of any gift or favour or other thing or value:*:
Maintain records and accounts in such form and manner as may be directed from time to time by an Assistant Commissioner of Customs or Deputy Commissioner or Customs for a period of five years and submit them for inspection to the Assistant Commissioner of Customs or an officer authorised by him, wherever required:*:
Comply with the provisions and abide by all the provisions of the Act and the rules, regulations, notifications and orders issued there under:*:
Intimate any change in respect of the information provided in the aforesaid application within a period of 30 days:*:
SIGNATURE OF THE APPLICANT/AUTHORISED SIGNATORY*  :  
Date:*: Mon Dec 05 10:40:16 IST 2022  
Place:*:  
(All the fields marked with * are mandatory.)

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