China AQSIQ Certificate application form

1. China AQSIQ AGENT: WWW.AQSIQ.ORG
Recycling@aqsiqgov.com
Skype: AQSIQ-Justin
Application Form for Provisional Registration of Overseas
Supplier Enterprises of Imported Scrap Materials
Type of Application □First-time Application □Renewal Review
□ Change in Registration □Reapplication
Application Number
Name of Enterprise
Country/Region the Enterprise Located
Contact Person
Contact Tel. No.
Date of Application
day/month/year
Prepared by the General Administration of Quality Supervision, Inspection and
Quarantine of the People’s Republic of China
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2. China AQSIQ AGENT: WWW.AQSIQ.ORG
Recycling@aqsiqgov.com
Skype: AQSIQ-Justin
Name of Enterprise
Registered Address
Office Address(Actual
working location)
Legal Representative Area Zip .
Telephone No. Fax No.
E-mail
Certificate No. of Last
Provisional Registration
Expiry Date for
Certificate of Last
Provisional
Registration
Changes in Information of
Provisional Registration
Types of Scrap Materials
Exported for This
Application
General Information on the Enterprise
InformationonMajorDepartments/Selection
andProcessingPlants
Depa
rt
Nam
e
Office
Size(width&
Length)
Amount of
Employees
Chief Tel No.
Major
Producti
onand
Testing
Name
of
Equip
ment
Specificati
on and
Type
Main
Functio
n
Quanti
ty
Purchase
Year
Operating
Status
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3. China AQSIQ AGENT: WWW.AQSIQ.ORG
Recycling@aqsiqgov.com
Skype: AQSIQ-Justin
Equipment
Details on
Certification
of Enterprise’s
Quality
Control
System
Type of
Certificatio
n
Certification
Organization
Certificate
No.
Date of Issuance
Export of Scrap Materials of the Enterprise
Year Starting to
Export Scrap
Material
Date of Initial
Export of Scrap
Material to China
Major Sources of
Supply for Scrap
Materials
Major Ports for
the Shipment of
Scrap Materials
Export of Scrap
Materials to China
in the Past 3 years
Year Type Export
Volume
Passing Rate of
CIQ Inspection
and Quarantine
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4. China AQSIQ AGENT: WWW.AQSIQ.ORG
Recycling@aqsiqgov.com
Skype: AQSIQ-Justin
StatementofApplicant
This enterprise hereby applies for the provisional registration of overseas
supplier enterprises of imported scrap materials. This enterprise agrees to abide
by the laws and regulations on entry-exit inspection and quarantine and the
technical regulations on environmental protection of the People’s Republic of
China.
This enterprise hereby certify that the information provided is true and
correct, and agrees to bear reasonable expenses incurred during the process of
assessment, verification and acceptance, examination, supervision and
administration, and etc. by AQSIQ and the bodies authorized by AQSIQ.
The attached documents include ：
、
、
、
、
Signature of the legal representative ：
（ Stamp of Enterprise ）
day/month/year
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