1. Combined Nomenclature code: 

2. Precise product description taking into account customs tariff criteria: 

TARIC Classification: 

For chemical products only (mainly chapter 28+29 of Combined Nomenclature): 

3. (i)  CUS N° (Reference number in European Customs Inventory of Chemicals):

(ii) CAS N° (Chemical Abstracts Service Registry Number):

     (iii) Other N°:

• Further information including commercial denomination, mode of operation, intended use of the imported product, type of product in which it is to be incorporated and end-use of that product:

For chemical products only :

• Structural formula:      

• Products are subject to a patent : 

      Yes/No

 If yes, number of the patent and of issuing authority:

• Products are subject to an anti-dumping/anti-subsidy measure : 

      Yes/No

If yes, further explanation why a tariff suspension/quota is requested:

• Name and addresses of firms known in the EU approached with a view to the supply of identical, equivalent or substitute products (obligatory for quota requests) : 

Dates and results of these approaches: N/A 

Reasons for the unsuitability of the products of these firms for the purpose in question:

• Calculation of tariff quota volume :

Annual consumption of applicant:

Annual EU production

Requested tariff quota volume: 

• Special remarks : 

4. Indication of similar tariff suspensions or quotas:

5. Indications of existing binding tariff information:

6. Other remarks :

7. Request submitted by:

Address:

Tel/Fax:

E-mail:

 8. Anticipated annual imports for 2013 (first year of the validity period requested):

– value (in EUR): €

quantity (in weight and supplementary unit if applicable for CN code in question):

9. Current imports (for 20XX – 2 years) ( year preceding the year in which the request is made):

– value (in EUR):  €

– quantity (in weight and supplementary unit if applicable for CN code in question):

 10. Applicable duty rate at the time of the request (including preferential agreements, free trade agreements, if they exist for the origin of the requested goods):

Third country duty rate:

Preferential duty rate applicable: yes/no (if yes, duty rate:..)

11. Estimated uncollected customs duties (in EUR) on an annual basis:  €

12. Origin of requested goods:

Name of non EU producer:

Country:

13. Names and addresses of the user in the EU: 

Address:

Tel/Fax:

E-mail:

14. Declaration by the interested party that the imported products are not the subject of an exclusive trading agreement (join extra-sheet- see Annex II to do this communication) (obligatory).

N° de la demande :

Code NC :

Désignation des marchandises :

N°  de fiche :

Les marchandises sont actuellement produites dans l’Union européenne ou en Turquie et sont disponibles sur le marché.

Des produits équivalents ou de substitution sont actuellement disponibles dans l'Union européenne ou en Turquie.

Remarques explicatives (différences, pourquoi et comment ce produit peut remplacer le produit demandé) :

Des fiches techniques qui prouvent le caractère et la qualité du produit proposé doivent être jointes.

Autres :

Proposition de compromis (commentaires explicatifs) :          

1. Transfert dans un contingent tarifaire - Volume du contingent suggéré :
2. Suspension tarifaire partielle - Taux de droit suggéré :
3. Autres propositions :

Remarques :

Entreprise produisant actuellement un produit identique, équivalent ou de substitution au sein de l’UE ou en Turquie

Dénomination sociale:

Personne à contacter:

Adresse:

Tél.:

Fax:

Courriel:

Nom commercial du produit:

Capacité de production (disponible pour le marché ; par exemple, pas lié en interne ou par des contrats) :

Actuelle :

Dans les 6 prochains mois :