Application for Certificate of Origin
Applicant Firm Name * I.E.C. Number *
Address of Applicant Firm *
State * City *
Pin Code * Email *
Office * - Fax * -
RCMC Number and Date
(If applicable)

 
H.S. Number H.S. Name
Transportation Details
Origin Criteria Means of Transport *
Port of Discharge * Name of Vessel
Container Number  
Payment Details
Payment Option * Amount
  *   *
Bank Name Payment Branch
Invoice Details
Invoice Number * Invoice Date *
Consignee Details * Consignee Address *
Consignee Country * Gross Weight
Net Weight Meters/Pcs/Sets
Invoice Items Details
Marks and No. of Packages*
Display of Description Of Goods ? OR
Description of Goods
Description*
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