K…wlB mg„w× MYcÖRvZš¿x evsjv‡`k miKvi

K…wl m¤úªmviY Awa`ßi

Dw™¢` msMwb‡iva DBs
Lvgvievwo, XvKv|
www.dae.gov.bd
¯§viK bs: 3369 ZvwiL: 18-05-2015Lªxt

D`¨vb dmj ißvwbKviK wbe܇bi weÁwß

evsjv‡`k †_‡K BD‡ivcxq BDwbqbmn we‡k¦i Ab¨vb¨ †`kmg~‡n kvK mewR, dj, cvb, Avjy ißvwbK‡í wbw`©ó msL¨K
ißvwbKviKMY‡K †iwR‡óªkb cÖ`vb Kiv n‡e| †hvM¨Zv m¤úbœ ißvwbKviKMY‡K wb¤œewY©Z kZ© mv‡c‡ÿ AvMvwg 18-06-2015
wLª: Zvwi‡Li g‡a¨ cÖ‡qvRbxq KvMRcÎmn wba©vwiZ Q‡K Av‡e`bcÎ `vwLj c~e©K †iwR‡óªkb m¤úbœ Kivi Rb¨ Aby‡iva Kiv
n‡jv| †iwR‡óªkb msµvšÍ mKj dig I Z_¨vejx wWGB Gi I‡qemvBU (www.dae.gov.bd ) Ges wb¤œ¯^vÿiKvixi `߇i
cvIqv hv‡e|

kZ©mg~n :

1| ißvwbKviKMY Dw™¢` I Dw™¢`RvZ cY¨ ißvwbi †ÿ‡Î Avg`vwbKviK †`‡ki Avg`vwb kZ© (Import Requirement )
Abyhvqx Action Plan Gi AvIZvq GjvKv I dmjwfwËK Pzw³e× K…l‡Ki gva¨‡g kvKmewR, dj , cvb I Avjy Drcv`b
Ki‡eb|

2| ißvwbKviKMY‡K Pzw³e× K…l‡Ki wbKU n‡Z evjvBgy³ kvKmewR, dj, cvb, Avjy msMÖn Kiv n‡q‡Q g‡g© mswkøó
Dc‡Rjv K…wl Awdmv‡ii wbKU n‡Z cÖZ¨qbcÎ msMÖn Ki‡Z n‡e|

3| Dc‡Rjv K…wl Awdmv‡ii cÖZ¨q‡bi wfwˇZ Ges m‡iRwg‡b cwi`k©b (physical inspection) c~e©K Dw™¢` msMwb‡iva
†K‡›`ªi Kg©KZ©v dvB‡Uv‡m‡bUvwi mvwU©wd‡KU (Phytosanitary Certificate) Bm¨y Ki‡eb|

4| ißvwbKviKMY GjvKv I dmjwfwËK K…lK‡`i mv‡_ wba©vwiZ †iwR‡óªkb d‡g©i gva¨‡g Pzw³e× n‡eb| Pzw³e× K…l‡Ki
ZvwjKv wWGB Gi Dc‡Rjv, †Rjv I Dw™¢` msMwb‡iva DBs G Rgv †`‡eb|

5| dmj Drcv`bKvjxb mg‡q Plant Quarantine Wing ( PQW ) / Research Organization / Hortex Foundation
/ BADC / BFVAPEA / BPEA Gi Kg©KZ©vMY wbqwgZ gvV cwi`k©b I g~j¨vqb Ki‡eb|

6| ißvwbKviKMY‡K Pzw³e× K…lK‡`i cÖwkÿY cÖ`vb, gvwU cixÿv, †m‡Pi cvwb cixÿvi e¨e¯’v wb‡Z n‡e|

Av‡e`b c‡Îi mv‡_ wb‡¤œv³ cÖ‡qvRbxq nvjbvMv` KvMRcÎmg~‡ni d‡UvKwc / Abywjwc mshy³ Ki‡Z n‡e :

(1) ißvwb wbeÜb mvwU©wd‡KU ( Export Registration Certificate)

(2) f¨vU †iwR‡óªkb mvwU©wd‡KU

(3) B - wUb mvwU©wd‡KU

(4) BFVAPEA / BPEA Gi m`m¨ mvwU©wd‡KU

5| †UªW jvB‡mÝ mvwU©wd‡KU

6| RvZxq cwiPqcÎ
(Qwe nwi`vm)
cwiPvjK
†dvb: 9131296
dpqw@dae.gov.bd
Abywjwct
1| wmwbqi mwPe, evwbR¨ gš¿Yvjq, evsjv‡`k mwPevjq, XvKv|
`„wó AvKl©b : DcmwPe (ißvbx)
2| mwPe, K…wl gš¿Yvjq, evsjv‡`k mwPevjq, XvKv|
3| AwZwi³ mwPe I gnvcwiPvjK (exR DBs), K…wl gš¿Yvjq|
4| fvBm †Pqvig¨vb, ißvbx Dbœqb ey¨‡iv, wUwmwe feb, XvKv|
5| gnvcwiPvjK, K…wl m¤úªmviY Awa`ßi, Lvgvievwo, dvg©‡MU, XvKv|
6| cwiPvjK, ......................................................DBs, K…wl m¤úªmviY Awa`ßi, Lvgvievwo, dvg©‡MU, XvKv|
7| Kwgkbvi, Kvógm nvDm, XvKv|
8| cwiPvjK, †emvgwiK wegvb PjvPj KZ…©cÿ, nhiZ kvn&Rvjvj AvšÍ©RvwZK wegvb e›`i, XvKv |

weZib :
1| DccwiPvjK, Dw™¢` msMwb‡iva †K›`ª, ..............................................................................|
2| mfvcwZ/mvavib m¤úv`K, evsjv‡`k d«zUm, †fwR‡Uejm GÛ GjvBW †cÖvWv±m G·‡cvU©vm© G‡mvwm‡qkb (BFVAPEA),
ingvwbqv Kg‡cø·, 28/1/wm U‡qbex mvK©yjvi †ivW, gwZwSj, XvKv|
3| mfvcwZ/mvavib m¤úv`K, evsjv‡`k c‡U‡Uv G·‡cvU©vm© G‡mvwm‡qkb, 67, cyivbv cëb jvBb, XvKv-1000|
4| Rbve gÄyiæj nK, Dc‡`óv, evsjv‡`k d«zUm, †fwR‡Uejm GÛ GjvBW †cÖvWv±m G·‡cvU©vm© G‡mvwm‡qkb (BFVAPEA),
ingvwbqv Kg‡cø·, 28/1/wm U‡qbex mvK©yjvi †ivW, gwZwSj, XvKv|
5| Rbve .....................................................................................................................|
 Application form for Registration as Horticultural Products Exporter
D`¨vb dmj ißvwbKviK wn‡m‡e wbeÜxKi‡bi Av‡e`b dig

(evsjv I Bs‡iRx‡Z dig c~iY Ki‡Z n‡e )

To/ eivei
Director/ cwiPvjK
Plant Quarantine Wing/ Dw™¢` msMwb‡iva DBs
Department of Agricultural Extension / K…wl m¤úªmviY Awa`ßi
Khamarbari/ Lvgvievwo, Dhaka-1215 / XvKv - 1215|

1. Name :
bvg :
2. Father’s Name :
wcZvi bvg :
3. Mother’s Name :
gvZvi bvg :
4. Date of Birth/ Age :
R‡b¥i ZvwiL / eqm :
5. Address/ wVKvbv :
a. Mailing address :

‡hvMv‡hv‡Mi wVKvbv :

b. Permanent address :

¯’vqx wVKvbv :

c. Name & address of Business Centre :

e¨emv cÖwZôv‡bi bvg I wVKvbv :

d. Telephone Number: e. Mobile Number :

f. E- mail Number : g. Fax Number:
6. National ID Number :
RvZxq cwiPqcÎ b¤^vi :
7. E – Tin Number :
B wUb b¤^i :
8. Company registration Number :
‡Kv¤úvwb †iwR‡÷ªkb b¤^I :
9. Trade Licence Number :
‡UªW jvB‡mÝ b¤^i :
10. Vat Registration Number :
f¨vU †iwR‡÷ªkb b¤^i :
11. Name of Sister Organization / Organizations :
mn‡hvMx ms¯’v / ms¯’vmg~‡ni bvg :
a. Company registration Number / s :
‡Kv¤úvwb †iwR‡÷ªkb b¤^i :
b. Vat Registration Number / s :
f¨vU †iwR‡÷ªkb b¤^i :
12. Experience of Vegetables/ Fruits/ Betel Leaf/ Potato Export ................Year :

kvK mewR/ dj/ cvb/ Avjy ißvwb msµvšÍ Kv‡Ri AwfÁZv ......... eQi :

13. Lists of Exportable item :

ißvbx c‡b¨i ZvwjKv :

14. Date and Member Number of BFVAPEA / BPEA

BFVAPEA/ BPEA Gi m`m¨ b¤^i I ZvwiL :

Day Month Year Member No

w`b gvm eQi m`m¨ b¤^i :

Signature of the Applicant (Seal)

`iLv¯ÍKvixi ¯^vÿi (mxj )

Signature of the Registration Authority

wbeÜb cÖ`vbKvix KZ…©c‡ÿi ¯^vÿi (mxj )