[Table 1]
BOND LICENSE APPLICATION FORM
Section A
1. Name of the Manufacturing Unit **NICCA will operate warehouse. | NICCA BANGLADESH CO., LTD.
2. Address of the Manufacturing Unit :
Holding No. | Lot No. C6
Road No. | Bangladesh Special Economic Zone (BSEZ)
Area/Village | Sonpara
Mowja | Panchrukhi Via Rupganj,
Union | Araihazar
Upazila | N/A
District | Narayanganj
Police station | Araihazar
Ward | N/A
City Corporation/Powrashova | N/A
Phone/PABX no
Fax no.
Mobile no | 880-173-590-1417
E-mail | kotakeuchi@niccachemical.com
3. Name of the Head Office | NICCA BANGLADESH CO., LTD.
4. Address of the Head Office
Holding No. | Lot No. C6
Road No. | Bangladesh Special Economic Zone (BSEZ)
Area/Village | Sonpara
Mowja | Panchrukhi Via Rupganj,
Union | Araihazar
Upazila | N/A
District | Narayanganj
Police station | Araihazar
Ward | N/A
City Corporation/Powrashova | N/A
Phone/PABX no
Fax no.
Mobile no | 880-173-590-1417
E-mail | kotakeuchi@niccachemical.com
5. Manufacturing Unit Premises [Please tick]
5a. | Hired | Deed no, if any | Date | CS Dag No
Exp. | RS Dag No
Owned | Dalil no, if any | Date | CS Dag No
RS Dag No
**We are warehouse operator and we have Warehouse Premises.
[Table 2]
5b.Whether there was any other bonded factory before at the same premises | Yes | ü | No
If Yes, Bond License No., if any
6. Type of Bond [Please tick] | Special Bonded Warehouse | Private Bonded Warehouse
2. Address of the Manufacturing Unit : | Subcategories
Direct | Supervised Bond
Direct & Deemed | Home Consumption Bond
Continuous Bond | Export processing Zone
**NICCA's nature will be Commercial Warehouse and category will be Deemed Exporter. | Privileged/Diplomatic Bond
Continuous Bond
Commissariat
ü | Deemed
Direct
Direct & Deemed
7. Category of Bond [Please tick]
✓ | A (100% Foreign investment) | B (Both Local & Foreign investment) | C (100% Local investment)
Number | Date
8. TIN | 898325152243 | Issue | 11/10/23
9. BOI / BSCIC Reg. no. | N/A | Issue
10. ERC no. | N/A | Issue
Exp.
For EZ Company ERC is not applicable. EZ company need only IP and EP.
11. IRC no. | Issue
Exp.
For EZ Company IRC is not applicable
12. VAT Reg. no. (BIN) | 005911976-0304 | Issue | 4/1/24
13. Trade License no. | TL-20231204094407991453 | Issue | 8/7/26
Exp. | 30/06/2027
14. Fire License no. | Date
Exp
15. Enrolment (if any):
a. Enrolled with [tick] | BGMEA | BKMEA | BLMEA | BGAPMEA | BPGMEA
Other (specify): Japan-Bangladesh Chamber of Commerce and Industry (JBCCI)
b. Membership no | N- 28 | Issue | 4/8/26
Exp. | 30/06/2027
16. Environmental Certificate no (If Applicable) | ২২.০২.৬৭০০.১৪০.০৭১.২৮১.২৫.২৩৮৪ | Issue | 27/08/2026
Exp. | 22/04/2027
17. Lien Bank
Code | Name | Branch | Address | Fax | Solvency certificate issuing bank [please tick]
HSBCBDDH | The Hongkong and Shanghai Banking Corporation Limited, Bangladesh (HSBC Bangladesh) | Gulshan Branch | Anabil Tower (2nd Floor) Plot # 3, Block – NW(J), Gulshan North Avenue (Kemal Ataturk Avenue), Gulshan, Dhaka 1212, Bangladesh | Phone: 88 09612772600 | ü
[Table 3]
Section B
18. Owner’s Information
Ownership Category [tick]:
2. Address of the Manufacturing Unit : | Proprietorship | Partnership | ✓ | Private Limited | Public Limited
Name of Proprietor/Chairman or MD/ Managing Partner | Mr. Kotaro Takeuchi Nominee Director of NICCA CHEMICAL CO., LTD., Managing Director
Father/Husband's Name | Kenichi Takeuchi
TIN | Date
Present Address | Suvastu Gafur Riz Garden, 10B, House#96, Road#23, Block-A, Banani Dhaka-1213, Bangladesh.
Permanent Address | 54-28, Ishizuka, Harue-cho, Sakai-shi, Fukui, Japan.
Residence Phone no.
Mobile no. | +88 0173 5901417
Passport no. (if any) | TT1404083 | Date
Place of Issue of passport, if any | Fukui, Japan
National ID No (For Bangladeshi) | N/A
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
19. Director's/Partner's Information (for Limited/Partnership Company)
Name of Proprietor/Chairman or MD/ Managing Partner | Mr. Yasumasa Emori Nominee Director of HONG KONG NICCA CHEMICAL CO., LTD., Chairman
Father/Husband's Name | Mikio Emori
TIN
Present Address | Date
Permanent Address | 1-609, keya, Fukui-city, Japan.
Residence Phone no. | 2-1-30, hoei, Fukui-city, Japan.
Mobile no. | 81-90-3297-3185
Passport no. (if any) | TS1580066
Place of Issue of passport, if any | Fukui, Japan
National ID No (For Bangladeshi) | N/A
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
20. Director's/Partner's Information (for Limited/Partnership Company)
Name | Mr. Atsutaka Kobayashi Nominee Director of NICCA CHEMICAL CO., LTD., Director
Father/Husband’s Name | Yasukuni Kobayashi
TIN | Date
Present Address | 1-609, keya, Fukui-city, Japan.
Permanent Address | 907, Nittazuka-cho, Fukui-city, Fukui, Japan.
Residence Phone no.
Mobile no. | 81-90-3297-3185
Passport no. (if any) | TZ1040129 | Date
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
[Table 3A]
Section B
18. Owner’s Information
Ownership Category [tick]:
2. Address of the Manufacturing Unit : | Proprietorship | Partnership | ✓ | Private Limited | Public Limited
Name of Proprietor/Chairman or MD/ Managing Partner | NICCA CHEMICAL CO., LTD. Represented By: Mr. Yasumasa Emori
Father/Husband's Name
TIN | Date
Present Address
Permanent Address
Residence Phone no.
Mobile no.
Passport no. (if any) | Date
Place of Issue of passport, if any
National ID No (For Bangladeshi)
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
Name of Proprietor/Chairman or MD/ Managing Partner | HONG KONG NICCA CHEMICAL CO., LTD. Represented By: Mr. Kotaro Takeuchi
Father/Husband's Name
TIN | Date
Present Address
Permanent Address
Residence Phone no.
Mobile no.
Passport no. (if any) | Date
Place of Issue of passport, if any
National ID No (For Bangladeshi)
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
[Table 4]
Place of Issue of passport, if any | Fukui, Japan
National ID No (For Bangladeshi) | N/A
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
20. Director's/Partner's Information (for Limited/Partnership Company)
Name | Mr. Atsutaka Kobayashi Nominee Director of NICCA CHEMICAL CO., LTD., Director
Father/Husband’s Name | Yasukuni Kobayashi
TIN | Date
Present Address | 1-609, keya, Fukui-city, Japan.
Permanent Address | 907, Nittazuka-cho, Fukui-city, Fukui, Japan.
Residence Phone no.
Mobile no. | 81-90-3297-3185
Passport no. (if any) | TZ1040129 | Date
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
[Table 4A]
20. Director's/Partner's Information (for Limited/Partnership Company)
Name | Mr. Kotaro Takeuchi Nominee Director of NICCA CHEMICAL CO., LTD., Managing Director
Father/Husband’s Name | Kenichi Takeuchi
TIN | Date
Present Address | Suvastu Gafur Riz Garden, 10B, House#96, Road#23, Block-A, Banani Dhaka-1213, Bangladesh.
Permanent Address | 54-28, Ishizuka, Harue-cho, Sakai-shi, Fukui, Japan.
Residence Phone no.
Mobile no. | +88 0173 5901417
Passport no. (if any) | TT1404083 | Date
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
21. Director's/Partner's Information (for Limited/Partnership Company)
Name | Mr. Yasumasa Emori Nominee Director of HONG KONG NICCA CHEMICAL CO., LTD., Chairman
Father/Husband’s Name | Mikio Emori
TIN | Date
Present Address | 1-609, keya, Fukui-city, Japan.
Permanent Address | 2-1-30, hoei, Fukui-city, Japan.
Residence Phone no.
Mobile no. | 81-90-3297-3185
Passport no. (if any) | TS1580066 | Date
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
22. Director's/Partner's Information (for Limited/Partnership Company)
Name | Mr. Atsutaka Kobayashi Nominee Director of NICCA CHEMICAL CO., LTD., Director
Father/Husband’s Name | Yasukuni Kobayashi
TIN | Date
Present Address | 1-609, keya, Fukui-city, Japan.
Permanent Address | 907, Nittazuka-cho, Fukui-city, Fukui, Japan.
Residence Phone no.
Mobile no. | 81-90-3297-3185
Passport no. (if any) | TZ1040129 | Date
Signature and Photo | Put your signature here | Attach one copy passport size recent photograph
[Table 4 (2)]
Section C 20. Manufactured Goods Information
**NICCA will import below finished goods and supply to the deemed exporters.
Description of Goods to be manufactured (as per the reg. No. of BOI/BSCIC/…................)
Sl. No. | HS Code | Commercial Description
1 | 3402.9 | HEMATEX AD, Sodium Salt of Homo Polymer of Acrylic Acid
2 | 3402.39 | Gujmol NKS powder, Naphthalene sulphonic acid formaldehyde Condensate, sodium salt.
3 | 3402.39 | Setavin PMD, Sodium salt of poly-naphthalene sulfonic acid
4 | 2922.49 | NTA Powder, Nitrilotriacetic acid, trisodium salt, monohydrate
5 | 2915.11 | FORMIC ACID 90%, Formic acid
6 | 2915.21 | ACETIC ACID Glacial 99%, Acetic acid
7 | 2918.14 | CITRIC ACID, Citric acid anhydrous
8 | 2922.49 | TRILON A92R, Nitrilotriacetic acid trisodium salt
9 | 2918.16 | SODIUM GLUCONATE, sodium gluconate
10 | 3906.9 | POIZ 530N, Polycarboxylate polymer
11 | 3808.92 | NEOSINTOL BC-230, Mixture
12 | 2828.9 | Sodium Hypochlorite, Sodium Hypochlorite
(Please use separate sheet if needed) 21. Total Area of the factory
SL | Length ( ft ) | Width ( ft ) | Area (Sq-ft )
1 | 61.5 m = 201.77 ft ≈ 201 ft 9 in | 57.7 m = 189.30 ft ≈ 189 ft 4 in | 38,196.27
**NICCA is maintaining only warehouse, no manufacturing unit.
22. Raw Materials Warehouse:
SL | Length ( ft ) | Width ( ft ) | Height ( ft ) | Volume (Cubic-ft )
1 | 61.5 m = 201.77 ft ≈ 201 ft 9 in | 57.7 m = 189.30 ft ≈ 189 ft 4 in | 7.6 m = 24.93 ft ≈ 24 ft 11 in | 952,400.54
23. Finished Goods Warehouse (If Applicable):
SL | Length ( ft ) | Width ( ft ) | Height ( ft ) | Volume (Cubic-ft )
1 | 61.5 m = 201.77 ft ≈ 201 ft 9 in | 57.7 m = 189.30 ft ≈ 189 ft 4 in | 7.6 m = 24.93 ft ≈ 24 ft 11 in | 952,400.54
**NICCA have only warehouse.
24. Raw Materials Information: Description of Raw Materials and Accessories (if applicable) as per the installed machineries:
Sl. No. | HS Code | Commercial Description
1 | 3402.9 | HEMATEX AD, Sodium Salt of Homo Polymer of Acrylic Acid
2 | 3402.39 | Gujmol NKS powder, Naphthalene sulphonic acid formaldehyde Condensate, sodium salt.
3 | 3402.39 | Setavin PMD, Sodium salt of poly-naphthalene sulfonic acid
4 | 2922.49 | NTA Powder, Nitrilotriacetic acid, trisodium salt, monohydrate
5 | 2915.11 | FORMIC ACID 90%, Formic acid
6 | 2915.21 | ACETIC ACID Glacial 99%, Acetic acid
7 | 2918.14 | CITRIC ACID, Citric acid anhydrous
8 | 2922.49 | TRILON A92R, Nitrilotriacetic acid trisodium salt
9 | 2918.16 | SODIUM GLUCONATE, sodium gluconate
10 | 3906.9 | POIZ 530N, Polycarboxylate polymer
11 | 3808.92 | NEOSINTOL BC-230, Mixture
12 | 2828.9 | Sodium Hypochlorite, Sodium Hypochlorite
** NICCA does not have raw materials, Nicca will import finished goods and sell it.
[Table 5]
25. Installed Machineries Information 25a. Description of the Machineries: | Section D
a. | Description
b. | Brand Name
2. Address of the Manufacturing Unit : | Model No.
d. | Manufacturing Year
e. | Country Of Origin
f. | Date Of Installation
g. | B/E No or VAT Challan No. | Date
h. | BL No. | Date
i. | Invoice No. | Date
j. | LC No. | Date
k. | No. of Machines
(Please use separate sheet if needed)
** NICCA does not have any machinary
25b. Product wise mother and auxiliary machineries and total production capacity:
Sl | HS Code of the Product to be produced | Commercial description of the Product to be produced | Mother Machine’s Description | Quantity/No. of mother machine of this type | Auxiliary Machines’ Descriptions | Annual Total Production Capacity of the Mother Machine | Unit
a. | 1.
2.
3.
4.
5.
b. | 1.
2.
3.
4.
5.
c. | 1.
2.
3.
4.
5.
(Please use separate sheet if needed)
**NICCA will not use any machinary so we do not have any production.
26. Indemnity Bond/Undertaking for import of Machineries (if any)
26a. Particulars of Importation for installed machineries:
SL no | B/E no | Date | Indemnity / Undertaking No | Date | Cash Memo /Challan/Voucher no | Date | Due date of release | Actual date of release
(Please use separate sheet if needed)
**NICCA will not import any machinary so it is not applicable for us.
[Table 6]
26b. If it is purchased from other bonded factory (after release of indemnity bond/Undertaking by importer)
SL | Clearance certificate No (From the BOI /BSCIC/………) | Date | Permission from Bond authority | Date | Transferor lien bank NOC no | Date | Bank Code | Bank Name | Bank Address
2. Address of the Manufacturing Unit :
(Please use separate sheet if needed)
**It is not applicable for NICCA.
27. Annual Import/local purchase Entitlement for raw materials:
SL | HSCODE | Description of the commodities | Specification/ Grade | Quantity | Unit
(Please use separate sheet if needed)
[Table 7]
Section E 28. Information of associate business (applicable for all Directors/partners)
a. | Name of the person who is doing the associate business
b. | TIN of that person
c. | NID of that person
d. | Name of the associate business
e. | Address of the associate business
f. | BIN of the associate business
g. | TIN of the associate business
h. | Nature of the associate business
i. | Position of that person in associate business
j. | Share of that person in associate business
(Please use separate sheet if needed)
29. Information about authorized signatory
Name of the authorized signatory | Signature of the authorized signatory | Photograph (one copy)
Mr. Kotaro Takeuchi
30. DECLARATION (by Chairman/MD/Proprietor/Sole Partner)
I declare that the particulars supplied by me in this application are correct and true in every respect.
Name (in BLOCK letters) | MR. KOTARO TAKEUCHI
Signature and seal
Designation of signatory | Managing Director | Date
Lot No. C6
Bangladesh Special Economic Zone (BSEZ)
Sonpara
Panchrukhi Via Rupganj,
Araihazar
Photograph (one copy)