ANNEXURE-A

DIRECTORATE OF EXPORT PROMOTION & MARKETING , ODISHA

RAPTANI BHAWAN, 1ST FLOOR, NAYAPALI, BHUBANESWAR-751015
Tel No: 0674-2552675, Fax- 22555268, E-Mail –depmodisha@gmail.com
APPLICATION FORM
STATE AWARD TO EXPORTERS OF ODISHA
The award shall be opened to all exporters in Odisha state including recognized Export Houses and
Government of India and State-Government Organization involved in export business.

The award would be for the financial year 2017-18. All Exporters desire to participate in the Export
Award Scheme Shall Furnish the Following information.

1. Name& Address of the Exporters : M/s. Hari Marine Pvt. Ltd

With Tel No/Fax.No/E-Mail etc. At-O.T . Road Po & Dist-Balasore-756001
Tel. No- 06782-260963/264555
E-Mail- harimarineexports@gmail.com
2. Factory address in case of
Manufacture Exporter : At- Biruan. Po-Sergarh, Dist-Balasore -756060
3. Importer Exporter Code No : 2314000935
4. Registration number allotted by the : 1330
Export Promotion Council if Registered
with them.
5. Name of the Banker : State Bank of India, I.E, SME Branch, Balasore-756001.
6. (a) Specify the category Whether : Small Scale Industries
Micro, Small, Medium and Large.
(b) Registration No. allotted by the : 0081300121
Directorate of Industries as Micro,
Small, Medium and Large Enterprise
(Copy of the Valid registration certificate enclosed)
7. Name of commodity exported during preceding two Financial years and during the award year.
Name of the ITC FOB Value of the goods exported Name of the Remarks
Commodity (HS)Code 2015-16 2016-17 2017-18 Country
1 2 3 4 5 6 7

Prawn 03061790 - 31,91,03,381/- 76,90,13,912/- Vietnam

Shrimps USA
Vennamai JAPAN
KOREA
CHINA
The year should be Financial year ending on 31st March.

(a) These figures should be supported by a Charterd Accountant Certificate with his Seal and
Signature, Full address and membership no.
(b) The Products Manufactured/ originated in Odisha only Should be reported.