REPORT ON DISTRIBUTION OF IMPORT-ORIGIN CFC
IT-CFC No.:
1. State Minister for Environmental Affairs;
2. Head of Food and Drug Agency;
3. Director General for International Commerce, Department of Trade and Industry;
4. Director General for Chemical Industry, Agribusiness, and Forest Produce, Department of Trade and Industry.
No., Name of User's Company, User's Address, Line of Business, Name of Distributed CFC, Utilization of CFC, Quantity (ton/kg), Date of Order, Date of Delivery, Remark
Signature & Company's Seal
(Name of Director of the Company)
MINISTRY OF TRADE AND INDUSTRY, DIRECTORATE GENERAL OF INTERNATIONAL COMMERCE
ACKNOWLEDGMENT AS IMPORTER AND PRODUCER OF CHLOROFLUOROCARBON (IP-CFC)
NO.:
With refernce to application signed by ... on behalf of ... (name of company) under letter No. ... dated ..., pursuant to decree of the minister of trade and industry No. ... dated ... on commercial procedures of import of CFC, we hereby grant:
ACKNOWLEDGEMENT AS IMPORTER AND PRODUCER OF CHLOROFLUOROCARBON (IP-CFC)
To :
Name/Type of Company :
Company's address :
Phone/fax :
Industrial Business Permit :
Industrial Register Certificate No. :
Producer/Limited API No. :
Company Register Certificate (TDP) No. :
Taxpayer's code no (NPWP) :
Recommendation ..... :
QUANTITY AND TYPE OF CFC, WHICH CAN BE IMPORTED IS AS SPECIFIED IN THE ATTACHMENT
In compliance with the following conditions:
1. CFC, as attached hereto, shall only be intended for need of self-production and shall be prohibited from being sold & purchased/traded, or assigned to any party;
2. Destination harbor: ...
3. Procedures of import of the said goods must be implemented based on the provisions of the applicable laws;
4. Implementation or non-implementation of import of CFC, as specified in the attachment hereto must be reported in writing to the Director General for International Commerce, Head of the Food & Drug Supervisory Agency, and the State Minister for Environmental Affairs every three (3) months from date of this acknowledgment;
5. In the event of expansion of production, which requires additional CFC to the designated one, you may file an additional application to the Director General for International Commerce and shall enclose evidence of permit of expansion and recommendation from Dirjen IKAHH and Head of Food & Drug Supervisory Agency;
6. Violations against the provisions set forth in paragraph (14) of decree of the minister of trade and industry No... dated... may be imposed by sanction in accordance with the applicable regulations;
7. This acknowledgment as IP-CFC shall be applicable up to ... (date).
Jakarta,
Cc:
1. Minister of Industry and Trade;
2. State Minister for Environmental Affairs;
3. Inspector General of the Department of Trade and Industry;
4. Director General for Customs ands Excise, Department of Finance;
5. Director General of Tax, Department of Finance;
6. Bank Indonesia/International Affairs;
7. Directorate General for ......, Department of Trade and Industry;
8. Head of Food and Drug Supervisory Agency;
9. Director for Import, Department of Trade and Industry;
10. Head of local Department of Trade and Industry Service;
11. Head of local Regional Office of Customs and Excise.