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Supply of card holders details for Biometric Smart Cards-reg.

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..... ce of the existing plastic coated magnetic strip based Customs passes which they are presently holding. The Biometric Smart Cards are mandatory. 2. The said Biometric Smart Cards will contain all the information related to the individual and the CHA concern/firm/company in digitally encoded form in an embedded electronic chip. The cards will have to be updated and revalidated every time there is a change in any of the details contained therein. These Biometric Smart Cards will serve as fool proof identification/authentication devices for the CHAs, their employees and Self card holders. 3. The substitution of the existing Customs passes with Biometric Smart Cards will be done in a phased manner beginning with the CHA s who operate in N .....

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..... 1 Name of the Custom House Agent M/s. 2 CHA Licence Number 11/ 3 Whether Proprietorship concern/Partnership firm/Private or Public Limited Company 4 Registered office address Full Address with Pincode: Landline Tel. No: Fax No.: Mobile No.: E-mail: Website: 5 Addresses of Mumbai Offices (Give addresses of all Mumbai Offices one after another) Full Address with Pincode: Landline Tel. No: Fax No.: Mobile No.: E-mail: .....

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..... Signatory : _______________________ Pass category and Kardex Number of the authorised signatory: __________________ Note:- 1) One form should be used to fill in the details for one person only. Separate forms should be used for each card holder. 2) The form should be TYPED and NOT Handwritten. 3) All details should be typed in CAPITAL BLOCK LETTERS ONLY 4) All boxes should be filled. No information should be left blank. 4) This format should be strictly adhered to. 5) CHAs can see the filled in sample form on the website (www.mumbaicustoms.gov.in) and accordingly fill the details in correct manner. 6) In case of any doubt please clarify with the CHA Section but do not submit partially filled/incomplete/wrongly fille .....

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