EXPORTERS DATA

 

                       NAME OF EXPORTER :
                       EXPORTER'S ADDRESS :
                       CITY :
                       STATE :
                       PINCODE :
                       TELEPHONES
                              Office :
                              Residence :
                              Fax :
                              Mobile :
                              Pager :
                              Telex :
                       IMPORTER-EXPORTER CODE (IEC) NO :
                       INCOME TAX PAN NO. :
                       BANK ACCOUNT NO. IN THE CANARA                        BANK PANAMBUR BRANCH,MANGALORE :
                       DETAILS OF BANK ACCOUNT(S)                        MAINTAINED FOR THE PURPOSE OF                        RECEIVING EXPORT SALE PROCEEDS
                        Name of the Bank :
                        Address :
                        Branch code :
                        Nature of account :
                        Account number :
              NAME AND SIGNATURE
              
             ( Authorised Signatory)

 

Notes

         1. Please enclose attested copies of IEC and PAN certificates

         2. All columns should be written legibly and in CAPITAL letters

         3. Exporters claiming drawback are requested to fill up Entry No. 9

             As drawback amounts would be credited only in their accounts maintained in the Canara Bank,              Panambur Branch, Mangalore. Against Entry No.10, please enclose separate sheets if you are              maintainin accounts  in more than one bank for the purpose of receiving the export proceeds

        
        4. Please enclose a certificate(s) from the bank(s) certifying the details at Entry No.10.