进口食品进出口商备案管理规定附件1

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u2014u2014企业信息Section 1-Applicantu2019s 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u2014u2014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u2014u2014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u2014u2014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Contractoru2019s office Telephone/Fax or cell phone：
*填表人电子邮件信箱Contractoru2019s E-mail Address：
*填表日期Date of submitting this form：
第5项u2014u2014填表说明Note
1、标u201c*u201d的项目必须填写。The above items with mark * must be effectively filled in.