Application Form for Authentication

Name of Afghan (Company, individual) _______________________________________

ID card No._____________Passport No.____________ Business License No._______

Date of Issue____________Date of Issue____________ Date of Issue______________

Date of Expiry__________ Date of Expiry___________Date of Expiry ____________

Address in Afghanistan: ____________________________________________________

Fax No.: _______________

Mobile No.: __________________

Purpose of Authentication: □ Power of Attorney

                                □ Agent

                                □ Others

If you have selected Power of Attorney, please provide us the followings:

• Copy of the Business License from Afghan side;

• Original of Power of Attorney document;

• Copy of Power of Attorney document;

• Copy of document that signed by Afghan and authorized by relevant agency;

• Copy of the passport from Afghan side.

If you have selected Agent, please provide us the followings:

• Manufacturer letter (the letter should indicate that the manufacturer has not given the same agency to others);

• Duration of the exclusive rights to agent;

• Copy of the passport from Afghan side;

• Copy of the Business License from Afghan side;

• Copy of the Contract with both parties’ signature & stamp.

If you have selected Others, please provide us information from authorized agencies along with passport (s) copy.

Number of Documents: _______________________________

Applicant’s Signature: _____________________ Date: ___________________

Remarks for Official Use Only:

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