Schedule 5
(Related to Sub-rule 2 of Rule 37)
Application for getting Customs Agent License
am submitting this application in compliance with the provisions of Sub- rule (2) of Rule 37 of Customs Rule, 2064. All the particulars mentioned above are true. I shall be responsible accordance with the prevailing law in case of proof that the particulars are false.
Date Thumb print
Right Left
Signature of the Applicant
Note: Enclose true copy of Certificate of Educational qualification, citizenship or passport and in case of firm or company enclose also true copy of certificate of PAN no., firm registration.
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Entrance card for the Customs Agent’s examination
Applicant’s name and surname:
Name of Firm/Company:
Roll Number:
Examination Centre:
Replica Signature