Application form for import of controlled substance in Schedule-C

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....u of Narcotics, Ministry of Finance, 19, The Mall, Morar, Gwalior, Madhya Pradesh-474 006, INDIA Tel. No .: 91-751-2368121 and 22368996/2368997 Fax No. : 91-751-2368111/2368577 Website: http://cbn.nic.in, https://cbnonline.gov.in Email: [email protected], [email protected] 6. Other operator/agent (name and address) 7a. Drug Controller's recommendation: 7b. Issuing authority (name and address) :   Telephone No .: Fax number: 8. Ultimate Consignee (in case of re-sale) (name and address): 9. Point of entry in India: 10. Mode of Transport: 11. Point of exit from exporting country: 12. Route: 13. Full name of substances to be imported: Quantity Weight/ Volume per unit 14. ....

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............................................................ (3) .......................................................... 21. Purpose of importation of the chemical. Are you a manufacturer or trader, please indicate. a) If trader, to whom the consignment will ultimately go. Name and address of the ultimate user, b) If manufacturer, how much finished product will be obtained from imported chemical (input- sale price and purpose of purchase by him. output ratio)? What is the selling price of finished product .......................................................... To what use will the chemicals be put? .......................................................... 22. Was the order made directly or through a br....

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...................... (Applicant) Stamp/ Seal Representing : ......................... Date .................................. List of documents to be submitted along with the application (i) copy of the registration under sub-clause(1) of clause 4 of this order if the controlled substance is also in Schedule-A (ii) Copy of agreement/contract/purchase order confirmation with the overseas seller (iii) Licence to import drugs for the purpose of examination, test or analysis (Form 11 of the Drugs and Cosmetic Rules 1945) issued by Drug Controller General (India) if the import is meant for test and analysis. (iv) Licence to import drugs (Form 10 of Drug and Cosmetic Rules 1945) issued by Drug Controller General (India) if t....