出口商或者代理商备案申请表.doc

出口商或者代理商备案申请表
Application Form of Food Exporter/Agent
□初次申请备案Initial Filing 
第1项——企业信息 Section 1-Applicant’s Information
*企业名称（中英文）Name (in Chinese AND English)
*企业地址（中英文）Address(in Chinese AND English)
*企业类型Company Type：□出口商Exporter  □代理商Agent
*国家（地区）Country/Region：
*邮政编码Postal Code
*联系人姓名Contact Name：
*联系人电话/传真（请注明国家/地区代码及区域码）或者手机
Contact Telephone/Fax (Include Area/Country/Region Code) or Cell Phone：
*联系人电子邮件信箱Contact E-mail：
*第2项——经营食品种类（多选项）Section 2-Food Category of Operation
□肉类 meat
□蛋及制品类 egg and egg products
□水产及制品类 aquatic products and preserved aquatic products
□中药材类 traditional Chinese medicinal materials of animal and plant origin
□粮谷及制品类 grains and grain products
□油脂及油料类 oil and oil seeds
□饮料类 soft drinks and drinking water
□糖类 sugar
□蔬菜及制品类 vegetable and vegetable products
□植物性调料类 processed flavorings of plant origin
□干坚果类 dried fruits and nuts
□其他植物源性食品类 other plant origin food
□罐头类 canned foods
□乳制品类 dairy products
□蜂产品类 bee products
□酒类 alcoholic beverage
□糕点饼干类 pastry biscuits and crackers
□蜜饯类 candied (preserved) fruits
□卷烟类 cigarette
□茶叶类 tea
□调味品类 processed flavorings
□其他加工食品类 other processed foods
□特殊食品类 foods for special dietary uses
□其他，请描述  others, please describe                               
第3项——中国贸易伙伴信息Section 3-Information of the Chinese Trade Partner to be contracted with:
企业名称（中文）Name (in Chinese)：
企业地址（中文）Address (in Chinese)：
联系人Contact person：
电话/传真 Telephone/Fax:
电子邮件信箱E-mail：
第4项——承诺书Section.4-letter of commitment
兹承诺: 上述资料信息准确、真实。I hereby commits: The information we submit is authentic and accurate.
*填表人姓名（印刷体）Contractor name (in printing version)：
*填表人电话/传真或者手机 Contractor’s office Telephone/Fax or cell phone：
*填表人电子邮件信箱Contractor’s E-mail Address：
*填表日期 Date of submitting this form：
第5项——填表说明 Note
1、标“*”的项目必须填写。 The above items with mark * must be effectively filled in.