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Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form 7 Form 10 Renewal Form 3 Form 8 Form 11 Premises Form 5 Quarterly Returns Form 4 Form 4 Form 4 Submission Copy of Environmental Protection Licence(EPL)- Central Environment Authority List of Dealers List of Dealers Copy of Environmental Protection Licence(EPL) - Central Environment Authority List of Dealers

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Page 1: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 1

INSTRUCTIONS

IMPORTER/EXPORTER DEALER END-USER

Registration Form 1 Form 6 Form 9

Amendment Form 2 Form 7 Form 10

Renewal Form 3 Form 8 Form 11

Premises Form 5

Quarterly Returns

Form 4 Form 4 Form 4

Submission Copy of Environmental Protection Licence(EPL)- Central Environment Authority

List of Dealers

List of Dealers

Copy of Environmental Protection Licence(EPL) -Central Environment Authority

List of Dealers

Page 2: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 2

For Importers/Exporters

Importer need to apply for:-

If importer/exporter is end using the licence chemicals further

Importer/Exporter(form1) + Premises(form4) + End-user(form9)

If importer/exporter is dealing the licence chemicals further

Importer/Exporter(form1) + Premises(form4) + Dealer(form6)

If importer/Exporter need to amend the licence according to

new quantities in same licence period

They want to apply:-

If they end-using the licence chemicals further

Importer /Exporter amend(form2) + End-user amend(form10)

If they dealing the licence chemicals further

Importer / Exporter amend(form2) + Dealer amend(form7)

Every year should be renew all the licences:-

Importer/Exporter renew (form3) + Premises(form4) + End-

user renew(form11) or Dealer renew(form8)

Page 3: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 3

Every Licensed importer or exporter shall obtain clearance from the

Central Environmental Authority for the purpose of storage &

disposal(Environmental Protection Licence)

Need to submit copy of Business Registration Certificate & copy of

Environmental Protection Licence to the Precursor Control Authority

Need to submit List of Dealers or End-users hope to deal or end-use

to the Authority

Need to submit Quarterly Returns(Form 5) once a three months

according to the calendar months

If a same importer deals with different names; need to apply for all

dealer names as dealers

If a importer obtain a end-using facility with different name; want to

apply for both as a importer & as a end-user

Page 4: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 4

Schedule A

Form 1

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for obtaining a license under sec. 19 of the Conventions against Illicit Traffic

In Narcotic Drugs and Psychotropic Substance Act No. 1 of 2008

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 5: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 5

Table II

Imp. Exp.

1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be imported or exported for next year.

Table 1

Imp. Exp.

1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 6: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form Page 6

Name of the

chemical

Trade Name

Probable

countries

which the

precursor

chemical

is to be

imported from

Transaction

company/

persons

whether for

trade or use,

if for usage

in which

industry it is

used

Necessary

Quantity

of precursor

chemical

for next year

remaining

quantity

at the stores

at present

Anticipated

quantity to be

imported

Potassium Permanganate

Condy's

Singapore

AB

Company

Use For

Purification

Industry

6,000kg

1,000kg

5,000kg

Name

of the

chemical

To whom

to be traded

for which

activity

to be

traded

Quantity

traded

Potassium Permanganate

CD

Company

Use For

Purification

Industry

6,000kg

Please provide details requested below, relevant to the precursor chemicals which are to be imported

for next year

Please provide details requested below by the Please provide details requested below by the

importers who import precursor chemicals importers who import precursor chemicals

for direct use for trade

Name of

the

chemical

The industries

which utilize

the precursor

chemicals and

address of the

Factory

Necessary

quantity

for next year

Potassium Permanganate

XYZ Lanka (Pvt) Ltd, No 0000, XYZ Rd, Col-00

6,000kg

Where are you

hope to buy

the chemicals

Shipment

quantity

Shipment q.

+

Remaining q.

Remaining

quantity

OR

Page 7: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 7

Please provide details requested below relevant to the precursor chemicals which are to be exported for next year

Name of

the

chemical

Trade Name

Probable countries

which the precursor

chemical is to be

exported to

Transaction

Company/person

for which activity

to be exported

The quantity to

be exported

for next year

_

_

_

_

_

_

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

Page 8: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 8

Schedule A

Form 2

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for amendment to the license under sec.19 of the Conventions against Illicit Traffic

In Narcotic Drugs And Psychotropic Substance Act No. 1 of 2008.

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 9: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 9

Table II

Imp. Exp.

1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be imported or exported for next year.

Table 1

Imp. Exp.

1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 10: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 10

Name of the

chemical

Trade Name

Probable

countries

which the

precursor

chemical

is to be

imported from

Transaction

company/

persons

whether for

trade or use,

if for usage

in which

industry it is

used

Necessary

Quantity

of precursor

chemical

for next year

remaining

quantity

at the stores

at present

Anticipated

quantity to be

imported

Potassium Permanganate

Condy's

Singapore

AB

Company

Use For

Purification

Industry

6,000kg

1,000kg

5,000kg

Name

of the

chemical

To whom

to be traded

for which

activity

to be

traded

Quantity

traded

Potassium Permanganate

CD

Company

Use For

Purification

Industry

6,000kg

Please provide details requested below, relevant to the precursor chemicals which are to be imported

for next year

Please provide details requested below by the Please provide details requested below by the

importers who import precursor chemicals importers who import precursor chemicals

for direct use for trade

Name of

the

chemical

The industries

which utilize

the precursor

chemicals and

address of the

Factory

Necessary

quantity

for next year

Potassium Permanganate

XYZ Lanka (Pvt) Ltd, No 0000, XYZ Rd, Col-00

6,000kg

Where are you

hope to buy

the chemicals

New

Shipment

quantity New Shipment q.

+

Remaining q.

Remaining

quantity

OR

Page 11: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 11

Please provide details requested below relevant to the precursor chemicals which are to be exported for next year

Name of

the

chemical

Trade Name

Probable countries

which the precursor

chemical is to be

exported to

Transaction

Company/person

for which activity

to be exported

The quantity to

be exported

for next year

_

_

_

_

_

_

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

Page 12: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 12

Schedule A

Form 3

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for renewal of a license under sec. 19 of the Conventions against Illicit Traffic

In Narcotic Drugs And Psychotropic Substance Act No. 1 of 2008.

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 13: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 13

Table II

Imp. Exp.

1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be imported or exported for next year.

Table 1

Imp. Exp.

1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 14: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 14

Name of the

chemical

Trade Name

Probable

countries

which the

precursor

chemical

is to be

imported from

Transaction

company/

persons

whether for

trade or use,

if for usage

in which

industry it is

used

Necessary

Quantity

of precursor

chemical

for next year

remaining

quantity

at the stores

at present

Anticipated

quantity to be

imported

Potassium Permanganate

Condy's

Singapore

AB

Company

Use For

Purification

Industry

6,000kg

1,000kg

5,000kg

Name

of the

chemical

To whom

to be traded

for which

activity

to be

traded

Quantity

traded

Potassium Permanganate

CD

Company

Use For

Purification

Industry

6,000kg

Please provide details requested below, relevant to the precursor chemicals which are to be imported

for next year

Please provide details requested below by the Please provide details requested below by the

importers who import precursor chemicals importers who import precursor chemicals

for direct use for trade

Name of

the

chemical

The industries

which utilize

the precursor

chemicals and

address of the

Factory

Necessary

quantity

for next year

Potassium Permanganate

XYZ Lanka (Pvt) Ltd, No 0000, XYZ Rd, Col-00

6,000kg

Where are you

hope to buy

the chemicals

Renew

Shipment

quantity Renew Shipment q.

+

Remaining q.

Remaining

quantity

OR

Page 15: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 4 Page 15

Please provide details requested below relevant to the precursor chemicals which are to be exported for next year

Name of

the

chemical

Trade Name

Probable countries

which the precursor

chemical is to be

exported to

Transaction

Company/person

for which activity

to be exported

The quantity to

be exported

for next year

_

_

_

_

_

_

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

Page 16: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 4 Page 16

Part 1

Details of the applicant and the premises

XYZ Lanka (Pvt) Ltd.

No.000,XYZ Rd,

Col-00

PV 0000

0000000

0000000

[email protected]

No.000,XYZ Rd, Col-00

Board of investments, Biyagama Export processing zone.

Transfer/ Lease

Schedule A

Form 4 (Regulation 9)

Precursor Control Authority Tel 011 2868794

No.383, Kotte

Road, Rajagiriya

Fax

E-mail

011 2868791

[email protected]

Application for registration of the Premises of the license under sec. 19(b) of the Conventions

Against Illicit Traffic In Narcotic Drugs And Psychotropic Substance Act No. 1 of 2008.

Name of the applicant :

Address of the applicant :

NIC No

Business Reg. No. / N(Pvc) No. :

Tel : :

Fax : :

E-mail : :

Address of the Premises :

From whom the premise is acquired :

Whether the premises was acquired : by a transfer / lease

Deed No. and date :

Name of the Notary :

Page 17: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 4 Page 17

Table II

Stored To be

Stored

1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are being stored in the premises and which are to be

stored in the premises

Table 1

Stored To be

Stored

1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 18: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 18

Yes

We use naturally ventilated, Semi-covered, open storage unit. The stores id kept as a separate building

away from the main building where production is carried out.

Yes

For disposal of these chemical wastes; a project is carried out with Holcim Geocycle.They take away

the chemical waste and dispose through thermal destruction.

The storage unit is kept locked at all times. This is opened only when chemicals are taken in or taken out.

The key is kept at the security office, and whoever takes the key has to state his/her name and sing. The

storage unit is manager by a separate personnel.

Are the prescribed methods being adopted for storage of the Precursor

Chemicals? If yes, please describe

Are the prescribed methods being adopted for disposal of the Precursor

Chemicals? If yes, please describe

Are the security measures being adopted to prevent unauthorized access to the premises or theft of

chemicals? If yes, please describe

I hereby declare that all the information furnished in this application is true and correct

…………………………… …………….….. ……………………….

signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

Page 19: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 19

Schedule A

Form 5

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Quarterly returns under sec. 19(e) of the Conventions against Illicit Traffic

In Narcotic Drugs and Psychotropic Substance Act No. 1 of 2008.

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 20: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 20

Table II

Imp. Exp.

1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which were imported or exported for last three months.

Table 1

Imp. Exp.

1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 21: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 21

Name

of the

chemical

To whom was

traded

for which

activity

Quantity

traded

during last

three

months

Potassium Permanganate

CD

Company

Use For

Purification

Industry

3,000kg

Please provide details requested below, relevant to the precursor chemicals which were imported

for last three months.

Name of the

chemical

Trade Name

Countries

which the

precursor

chemical was

imported from

Transaction

company/

persons

whether for

trade or use,

if for usage

in which

industry it is

used

Imported

Quantity of

precursor

chemical

during last

three months

Used / traded

quantity

during last three

months

Remaining

quantity

Potassium Permanganate

Condy's

Singapore

AB

Company

Use For

Purification

Industry

5,000kg

3,000kg

2,000kg

Please provide details requested below by the Please provide details requested below by the

importers who import precursor chemicals importers who import precursor chemicals

for direct use for trade

Name of

the

chemical

The industries

which utilize

the precursor

chemicals and

address of the

Factory

Used quantity

during last

three months

Potassium Permanganate

XYZ Lanka (Pvt) Ltd, No 0000, XYZ Rd, Col-00

3,000kg

Where were

you buy the

chemicals

Shipment

quantity Shipment q.

-

Used q.

Used

quantity

OR

Page 22: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 22

Please provide details requested below relevant to the precursor chemicals which were exported during

last three months.

Name of

the

chemical

Trade Name

Countries

which the

precursor chemical

was exported to

Transaction

Company /

person

For which

activity

was exported

The quantity

exported

for last

three

months

_ _ _ _ _ _

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

Please attach herewith the photocopies of the receipts, invoices and bills pertaining to the transactions done in the last three months

For official use only

Date received -

Checked by -

Approved by -

Page 23: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 23

For Dealers

Schedule A

Form 6

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for registration as a Dealer under the

Precursor Control Authority

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 24: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 24

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be dealt next year.

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

√ 13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Page 25: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 25

Please provide details requested below relevant to the precursor chemicals which are to be dealt for next year.

Name

of the

chemical

Trade Name

From whom to be

purchased

(Name & address)

To whom

to be sold

(Name &

address)

for which

activity

The quantity

dealt

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

EFG Lanka (Pvt) Ltd, No 0000, EFG Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

Please attach herewith the photocopies of the receipts, invoices and bills pertaining to the transactions done in the last three months.

For official use only

Date received -

Checked by -

Approved by -

All quantity

hope to deal in

next year

Page 26: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 26

Schedule A

Form 7

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for amendment to the registration as a Dealer

under the Precursor Control Authority

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 27: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 27

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which need to be included in the amendment.

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

√ 13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Page 28: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 28

Please provide details requested below relevant to the precursor chemicals which need to be included in the amendment

Name

of the

chemical

Trade Name

From whom to be

purchased

(Name & address)

To whom

to be sold

(Name &

address)

for which

activity

The quantity

of dealt

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

EFG Lanka (Pvt) Ltd, No 0000, EFG Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

Please attach herewith the photocopies of the receipts, invoices and bills pertaining to the transactions done in the last three months.

For official use only

Date received -

Checked by -

Approved by -

New quantity

hope to deal in

licence period

Page 29: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 29

Schedule A

Form 8

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for renewal of the registration as a Dealer

Under the Precursor Control Authority

Name of the applicant : XYZ (Pvt)Ltd

Address of the applicant : No 0000, XYZ Rd,

Col-00

NIC No :

Business Reg. No./ N(Pvc)

Tele : : 00000000

Fax : : 00000000

E-mail : : [email protected]

Part 1

Details of the Applicant

PV 0000

Page 30: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 1 Page 30

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be dealt next year.

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

√ 13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 31: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 9 Page 31

Please provide details requested below relevant to the precursor chemicals which are to be dealt next year.

Name of

the

chemical

Trade Name

From whom to

be purchased

(Name & address)

To whom

to be sold

(Name &

address)

for which activity

The quantity

of dealt

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

EFG Lanka (Pvt) Ltd, No 0000, EFG Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

…………………………… …….……………….. ……………..………………. signature of applicant Date Company Stamp

Please attach here the photocopies of the receipts, invoices and bills pertaining to the transactions done in the last three months.

For official use only

Date received -

Checked by -

Approved by -

Renew quantity

hope to deal in

next year

Page 32: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 9 Page 32

XYZ Lanka (Pvt)Ltd.

No.000,XYZ Rd,

Col-00.

PVC 0000

00000000

0000000

[email protected]

For End-users

Schedule A

Form 9 (Regulation 23)

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for registration as an End User

under the Precursor Control Authority

Part 1

Details of the applicant

Name of the applicant :

Address of the applicant :

NIC No :

Business Reg. No./ N(Pvc) No. :

Tel : :

Fax : :

E-mail : :

Page 33: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 9 Page 33

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be used for next year.

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 34: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 10 Page 34

Please provide details requested below relevant to the precursor chemicals which are to be used for next year.

Name

of the

chemical

Trade Name

From whom to be

purchased

(Name & address)

for which

activity

The expected

quantity to be

used for

next year

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

…………………………… …………….. ……………………….

signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

All quantity

hope to used in

next year

Page 35: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 10 Page 35

XYZ Lanka (Pvt)Ltd.

No.000, XYZ Rd,

Col-00.

PVC 0000

00000000

0000000

[email protected]

Schedule A Form 10 (Regulation 27)

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for amendment to the registration as an End User

under the Precursor Control Authority

Part 1

Details of the applicant

Name of the applicant :

Address of the applicant :

NIC No :

Business Reg. No./ N(Pvc) No. :

Tel : :

Fax : :

E-mail : :

Page 36: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 10 Page 36

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which need to be included in the amendment

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 37: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 11 Page 37

Please provide details requested below relevant to the precursor chemicals which need to be included in the amendment

Name

of the

chemical

Trade Name

From whom to be

purchased

(Name & address)

for which

activity

The expected

quantity to be

used for

current year

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

…………………………… …………….. ……………………….

signature of applicant Date Company Stamp

For official use only

Date received -

Checked by -

Approved by -

New quantity

hope to used in

licence period

Page 38: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 11 Page 38

XYZ Lanka (Pvt)Ltd.

No.000, XYZ Rd,

Col-00.

PVC 0000

00000000

0000000

[email protected]

Schedule A Form11 (Regulation 28)

Precursor Control Authority Tel 011 2868794

No.383, Kotte Road, Fax 011 2868791

Rajagiriya E-mail [email protected]

Application for renewal of the registration as an End User

under the Precursor control Authority

Part 1

Details of the applicant

Name of the applicant :

Address of the applicant :

NIC No :

Business Reg. No./ N(Pvc) No. :

Tel : :

Fax : :

E-mail : :

Page 39: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 11 Page 39

Table II 1. Acetone

HS Code : 2914.11

CAS No : 67-64-1

2. Anthranillic acid

HS Code : 2922.43

CAS No : 118-92-3

3. Ethyl ether

HS Code : 2909.11

CAS No : 60-29-7

4. Hydrocholic acid

HS Code : 2806.10

CAS No : 7647-01-0

5. Methyl ethyl ketone

HS Code : 2914.12

CAS No : 78-93.3

6. Phenylacetic acid

HS Code : 2916.34

CAS No : 103-82-2

7. Piperidine

HS Code : 2933.32

CAS No : 110-89.4

8. Sulphiric acid1

HS Code : 2807.00

CAS No: 7664-93-9

9. Toluene

HS Code : 2902.30

CAS No : 108-88-3

Part 2

Details of the precursor chemicals

Please indicate the precursor chemicals which are to be used for next year.

Table 1 1. Acetic Anhydride

HS Code : 2915.24

CAS No. 108-24-7

2. N-Acetylanthranillic acid

HS Code : 292423

CAS No. 89-52-1

3. Ephedrine

HS Code : 2939.41

CAS No. 299-42-3

4. Ergometrine

HS Code : 2939.61

CAS No. 60-79-7

5. Ergotamine

HS Code : 2939.62

CAS No. 113-15-5

6. Isosafrole

HS Code : 2932.91

CAS No. 120-58-1

7. Lysergic acid

HS Code : 2939.63

CAS No. 82-58-6

8. 3,4-Methylenediosyphenyl

1-2 propanone

HS Code : 2932.92

CAS No. 4676-39-5

9. Norephedrine

HS Code : 2939.49

CAS No. 154-41-6

10.1-Pheny1-2-propanone

HS Code : 2914.31

CAS No. 103-79-7

11. Piperonal

HS Code : 2932.93

CAS No. 120-57-0

12. Potassium permanganate

HS Code : 2941.61

CAS No. 7722-64-7

13.Pseudoephedrine

HS Code : 2939.42

CAS No. 90-82-4

14.Safrole

HS Code : 2932.94

CAS No. 94-59-7

Page 40: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 9 Page 40

Please provide details requested below relevant to the precursor chemicals which are to be used for next year.

Name of

the

chemical

Trade Name

From whom

to be purchased

(Name &

Address)

for which

activity

The expected

quantity

to be used

for next year

Potassium Permanganate

Condy's ABC Lanka (Pvt) Ltd, No 0000, ABC Rd, Col-00

Use For

Purification

Industry

6,000kg

I hereby declare that all the information furnished in this application are true and correct

For official use only

Date received -

Checked by -

Approved by -

…………………………… …………….. ……………………….

signature of applicant Date Company Stamp

Renew quantity

hope to used in

next year

Page 41: IMPORTER/EXPORTER DEALER END-USER - NDDCB · Form Page 1 INSTRUCTIONS IMPORTER/EXPORTER DEALER END-USER Registration Form 1 Form 6 Form 9 Amendment Form 2 Form …

Form 9 Page 41