Application Form for Provisional Registration of Overseas Supplier Enterprises of Imported Scrap Materials
Type of Application □First-time Application □Renewal Review
l Change in Registration □Reapplication
Application Number
Name of Enterprise
Country/Region the Enterprise Located
Contact Person
Contact Tel. No.
Date of Application
day/month/year
Prepared by the General Administration of Quality Supervision, Inspection and Quarantine of the People’s Republic of China
Name of Enterprise
Local language Name:
English Name:
Registered Address
Local language Address:
English Address:
Office Address(Actual working location)
Local language Address:
English Address:
Legal Representative
Area Zip .
Telephone No.
Fax No.
E-mail
Certificate No. of Last Provisional Registration
Expiry Date for Certificate of Last Provisional Registration
Changes in Information of Provisional Registration
Types of Scrap Materials Exported for This Application
General Information on the Enterprise
Information on Major Departments/Selection and Processing Plants
Depart Name
Office Size(width&Length)
Amount of Employees
Chief
Tel No.
Major Production and Testing Equipment
Name of Equipment
Specification and Type
Main Function
Quantity
Purchase Year
Operating Status
Details on Certification of Enterprise’s Quality Control System
Type of Certification
Certification Organization
Certificate No.
Date of Issuance
Export of Scrap Materials of the Enterprise
Year Starting to Export Scrap Material
Date of Initial Export of Scrap Material to China
Major Sources of Supply for Scrap Materials
Major Ports for the Shipment of Scrap Materials
Export of Scrap Materials to China in the Past 3 years
Year
Type
Export Volume
Passing Rate of CIQ Inspection and Quarantine
Statement of Applicant
This enterprise hereby applies for the provisional registration of overseas supplier enterprises of imported scrap materials. This enterprise agrees to abide by the laws and regulations on entry-exit inspection and quarantine and the technical regulations on environmental protection of the People’s Republic of China.
This enterprise hereby certify that the information provided is true and correct, and agrees to bear reasonable expenses incurred during the process of assessment, verification and acceptance, examination, supervision and administration, and etc. by AQSIQ and the bodies authorized by AQSIQ.
The attached documents include:
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、
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Signature of the legal representative:
(Stamp of Enterprise)
day/month/year
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