Application for IPC Award

Excellence in Manufacture of Innovative Product / Products of Pepper

INTERNATIONAL PEPPER COMMUNITY

APPLICATION FOR IPC AWARD FOR

EXCELLENCE INManufacture of Innovative Product /

Products of PepperFOR THE YEAR 2015

  1. Name of applicant
  2. Address of the applicant
  3. Building No.
  4. Building Name
  5. Street
  6. City Zip Code
  7. State Country
  8. Tel. Landline Mobile
  9. Fax Website
  10. Email
  1. Name of Managing Director/ Mr./Mrs./Ms.
    Managing Partner/Proprietor
  1. Total export of innovative products of pepper and imports of raw material & others for manufacturing the innovative productsduring the year 2015 with net foreign exchange earnings

Exports / Imports / Domestic Sales / Net foreign exchange earned
Qty (Mt) / Value(USD) / Qty (Mt) / Value(USD) / Qty (Mt) / Value(USD)
  1. Whether export/import statement certified by the bankers and chartered accountant for the above categories are attached?
  1. Details of Quality improvement measures adopted (if any)
  1. Whether the firm has any dispute with foreign buyers during the last 3 years? If so give details, reasons and product/country/party involved and present status of the dispute etc.
  1. Whether the firm has been at any time in the abeyance list, issued by Foreign Trade Department, Customs or Such Govt. authorities. If so the details

DECLARATION

I/We hereby certify that the information furnished in this form are correct to the best of my/our knowledge.

Place:
Date: / Signature:
Name:
Designation:
Name of the firm with Stamp

Performa A

EXPORT / IMPORT STATEMENT FOR SELECTING THE AWARD WINNER

Top-most Manufacturer of Innovative Product /

Products of Pepper – FOR THE YEAR 2015

Name & address of the Exporter
Details of the newly developed innovative pepper product(s)
Sale details of the newly developed pepper product(s) [in USD]
Name of the innovative product / Ingredients used / Countries to which exported/sold / Quantity (MT) / Value (USD)
Total value (A)
Imports - CIF value [Import details of Ingredients – pepper and others used for the manufacture
of the newly developed product(s)]
Name of
the Products imported / Countries from where imported / Quantity (MT) / Value (USD)
Total value (B)
Net Foreign Exchange earned (A) – (B)

Place: Signature

Date:Name & Designation:

(Office seal)

CERTIFICATE

We certify that the figures given above relate to exports and imports of pepper and pepper products by M/s.______for the period from 1st January 2015 to 31st December 2015. Further certified that the sale value given are in USD and import value in CIF. It is further certified that the total value of sales has been realized and credited to the firm’s account and the total amount payable for the import effected has been debited to the account of M/s………………

Place: Signature Signature

Date: Name & address of the Name & address of the bank

Chartered Accountant

[Seal] [Seal]

1