出口商或者代理商備案申請表

Application Form of Food Exporter/Agent

□初次申請備案Initial Filing
第1項u2014u2014企業(yè)信息Section 1-Applicantu2019s Information
*企業(yè)名稱（中英文）Name (in Chinese AND English)
*企業(yè)地址（中英文）Address(in Chinese AND English)
*企業(yè)類型Company Type：□出口商Exporter □代理商Agent
*國家（地區(qū)）Country/Region：	*郵政編碼Postal Code
*聯(lián)系人姓名Contact Name：
*聯(lián)系人電話/傳真（請注明國家/地區(qū)代碼及區(qū)域碼）或者手機 Contact Telephone/Fax (Include Area/Country/Region Code) or Cell Phone：
*聯(lián)系人電子郵件信箱Contact E-mail：
*第2項u2014u2014經營食品種類（多選項）Section 2-Food Category of Operation
□肉類meat □蛋及制品類egg and egg products □水產及制品類aquatic products and preserved aquatic products □中藥材類 traditional Chinese medicinal materials of animal and plant origin □糧谷及制品類grains and grain products □油脂及油料類oil and oil seeds □飲料類soft drinks and drinking water □糖類 sugar □蔬菜及制品類vegetable and vegetable products □植物性調料類processed flavorings of plant origin □干堅果類dried fruits and nuts □其他植物源性食品類other plant origin food □罐頭類canned foods □乳制品類dairy products □蜂產品類bee products □酒類alcoholic beverage □糕點餅干類pastry biscuits and crackers □蜜餞類candied (preserved) fruits □卷煙類cigarette □茶葉類tea □調味品類processed flavorings □其他加工食品類other processed foods □特殊食品類foods for special dietary uses □其他，請描述 others, please describe
第3項u2014u2014中國貿易伙伴信息Section 3-Information of the Chinese Trade Partner to be contracted with:
企業(yè)名稱（中文）Name (in Chinese)：
企業(yè)地址（中文）Address (in Chinese)：
聯(lián)系人Contact person：
電話/傳真Telephone/Fax:
電子郵件信箱E-mail：
第4項u2014u2014承諾書Section.4-letter of commitment
茲承諾: 上述資料信息準確、真實。I hereby commits: The information we submit is authentic and accurate.
*填表人姓名（印刷體）Contractor name (in printing version)：
*填表人電話/傳真或者手機Contractoru2019s office Telephone/Fax or cell phone：
*填表人電子郵件信箱Contractoru2019s E-mail Address：
*填表日期Date of submitting this form：
第5項u2014u2014填表說明Note
1、標u201c*u201d的項目必須填寫。The above items with mark * must be effectively filled in.