GAZİ MAĞUSA SERBEST LİMAN VE BÖLGESİ FAALİYET MÜRACAAT FORMU FAMAGUSTA FREE PORT & ZONE OPERATION APPLICATION FORM Port İSBİ Cyprus Free Zone & Marine Logistics Services Ltd. SERBEST BÖLGE VE LİMAN İŞLETMESİ FREE TRADE ZONE & PORT MANAGEMENT Gazi Mağusa Serbest Bölge ve Limanı G.Mağusa - KKTC Famagusta Free Trade Zone & Port Famagusta TRNC Tel: +(90) 392 365 63 90 (Pbx) Fax: +(90) 392 365 63 95 E-mail: info@portisbi.com 1
1-FALİYET RUHSATI TALEP EDENİN Operation Applicant TESCİL EDİLMESİ TASARLANAN KURULUŞUN Proposed Establishment To be Registered ADI TELEFON : Name FAKS : EMAIL : ADRESİ Adress FALİYETE GEÇME TARİHİ Proposed Date Of Operation BÖLGEDE YAPACAĞI FALİYET Proposed Zone Operation SERMAYESİ ÖDENMİŞ SERMAYİSİ ORTAK SAYISI Authorised Capital Paid-up Capital Number of Partners YERLİ PAYI Local Partners Share YABANCI PAYI Foreign Partners Share BAŞLICA ORTAKLARIN ADLARI UYRUĞU ÖDENMİŞ SERMAYE TURAR Name of Main Partner Nationality Paid-up Capital Amount (VARSA) KKTC DEKİ TEMSİLCİNİN ADI (If any) Representatives Name in TRNC. ADRESİ Address VARSA ANA ŞİRKETİN ADI (If any) Home Company s Name ADRESİ Address ANA FALİYET Main Line Of Business TELEFON PHONE FAKS FAX TELEFON: PHONE FAXS FAX EMAIL 2
KURULUŞ YILI SERMAYESİ ÖDENMİŞ SERMAYE Year of Establishment Authorised Capital Paid-up Capital VARSA KENDİSİNİN, ORTAKLARININ KKTC VE/VEYA DİĞER SERBEST BÖLGE VEYA ÜLKELERDEKİ FAALİYETLERİ (If any) Applicant s and/or Partners Operation in TRNC Or Any Other Free Zones or Countries FALİYET KONULARI ÜLKE BÖLGE ADI YATIRIM TUTARI(ABD$) Activities Country Name of Zone Investment Amount (US$) 2- YAPMAK İSTEDİĞİNİZ BÖLGE FAALİYETİ (UYGUN KARELERİ İŞARETLEYİNİZ) Proposed Zone Operation ( Mark Relevant Boxes) ÜRETİM Production ALIM, SATIM Purchasing, Selling DEPOLAMA Storing AMBALAJLAMA, ETİKETLEME, MARKALAMA Packing, Labelling, Marking MONTAJ, DEMONTAJ Assembling, Disassembling BAKIM, ONARIM Repair, Maintenance MAKİNE PARKI Machinery Parking TİCARİ VE SINAİ GÖZETİM Survey BANKACILIK Banking SİGORTACILIK Insurance DİĞERLERİ ( AŞAĞIDA BELİRTİNİZ) Other (Specify Below) 3
3- TALEP EDİLEN ALAN Required Area İNŞAATIN TABAN ALANI (M 2 ) Base Area Of the Construction (m 2) TALEP EDİLEN AÇIK ALAN (M 2 ) Reguired Open Areas (M 2 ) İNŞAATIN KAT SAYISI Number of Floors İNŞAATIN TİPİ Type Of Construction 4- TALEP EDİLEN OFİS VE İŞYERİ Required Office and Working Place TALEP EDİLEN OFİS SAYISI Number of Required Office KAPALI AÇIK Closed Open TALEP EDİLEN ALAN (M 2 ) Required Area (M 2 ) 5- YATIRIM HARCAMALARI (CARİ YIL FİYATLARI İLE) Investment Expenditures (In Current Years Prices) YAPILACAK ÖDEMELER (ABD $) Payments To Be Made (US $) KKTC YE DIŞARIYA To TRNC Abroad BİNA Construction MAKİNE, TEÇHİZAT Machinery and Equipment İŞ GÜCÜ Manpower DİĞERLERİ Others 4
TOPLAM Total TAHMİNİ DÖVİZ YATIRIM TUTARI The Estimated Amount of Foreign Currency to be Invested 6- ORTALAMA YILLIK İŞLETME HARCAMALARI (CARİ YIL FİYATLARI İLE) Average Annual Operating Expenditures (In Current Year s Prices) YAPILACAK ÖDEMELER (ABD $) Payments To Be Made (US $) KKTC YE DIŞARIYA To TRNC Abroad HAMMADDE VE ARA MALLARI Raw and Intermediate Goods İŞGÜCÜ Manpower KREDİ, ANAPARA VE FAİZ Credit, Principal And Interest GAYRİ MADDİ HAKLAR Intangible Rights KİRA Rent SİGORTA Insurance DİĞERLERİ Others TOPLAM Total 7- İHTİYAÇLAR Requirements SU Water M 3 /GÜN M 3 /Day ELEKTRİK KWA Electricity KWA 5
TELEFONLAR ADET Phones Unit TELEKS ADET Telex Unit FAX ADET Fax Unit 8- ORTALAMA YILLIK İSTİHDAM Average Annual Expendiare YÖNETİCİ Administrators KKTC UYRUKU Citizen YABANCI Foreign TOPLAM Total BÜRO PERSONELİ Office Personnel VASIFLI İŞCİ Qualified Workers TOPLAM Total 9- FAALİYETİNİZLE İLGİLİ ÇEVRE KİRLİLİĞİNİ NASIL ÖNLEYECEKSİNİZ. AÇIKLAYINIZ. Describe how you intend to prevent environmental pollution 10- BÖLGE FAALİYETİ VE TAMAMLAYICI İŞLEMLER Zone Operation and Complementry Activities 10-1. ÜRETİM Production ÜRETİM METODUNUZU VE/VEYA İŞLEMLERİNİ AKIM ŞEMASI İLE/ AÇIKLAYINIZ (EK 12.2) Describe your production process and/or Methods with a Flowchart (Enc. 12.2) 6
ÜRETİM LİSANS ALTINDA MI? (PATENT, MARKA VB) Production Under Licence? (Patent, trademark etc.) HAYIR No EVET Yes NUMARASI Number LİSANS ANLAŞMASI HAKKINDA KISA BİLGİ Brief Description of the Licence Agreement ORTALAMA YILLIK ÜRETİM Averange Annual Production MİKTAR Quantity DEĞER Value ÜRETİLECEK BAŞLICA MALLAR Goods to be Produced TOPLAM Total 7
10-2. ALIM SATIM Purchasing 10-2.1 SATIN ALMA Purchasing ORTALAMA YILLIK Annual Averge KKTC DEN From TRNC DIŞARDAN From Abroad MİKTAR DEĞER (ABD$ MİKTAR DEĞER (ABD$ 10-2.2 SATIŞ Selling SATILACAK BAŞLICA MALLAR Main Goods To Be Sold MİKTAR Quantity KKTC YE To TRNC DEĞER (ABD$) Value (US$) ORTALAMA YILLIK Annual Average DIŞARIYA (İHRACAT) Abroad (Export) MİKTAR DEĞER Quantity (ABD$) Value (US$) 10-.-3. DEPOLAMA Storage 8
DEPONUN CİNSİ Storage Type AÇIK Open KAPALI Close SOĞUK HAVA Cold Storage DİĞER (AÇIKLAYINIZ) Other (Specify) DEPOLANACAK BAŞLICA MALLAR Main Goods To Be Stored 10-4. AMBALAJLAMA /ETİKETLEME/MARKALAMA Packing/Labelling/Marketing AMBALAJLANACAK/ETİKETLENECEK/MARKALANACAJ MALLAR Goods To Be Packed/Labelled/Marked ORTALAMA YILLIK MİKTAR Annual Average Quantity 9
10-5. MONTAJ DEMONTAJ Assembling, Disassembling MONTAJI, DEMONTAJI YAPILACAK MALLAR Goods To Be Assembled, Disassembled ORTALAMA YILLIK MİKTAR Annual Averge Quantity 10-6. BAKIM, ONARIM Repair, Maintenance BAKIM, ONARIM YAPILACAK MALLAR Goods To Be Repaired, Maintained ORTALAMA YILLIK MİKTAR Annual Average Quantity 10-7. MAKİNE PARKI Machiney Parking PARK EDİLECEK MAKİNE ORTALAMA YILLIK MİKTAR EN AĞIR MAKİNA TONAJI Machinery To Be Parked Annual Average Quantity Weight Of the Heaviest Machine 11- BU FORMADAKİ VE EKLERİNDEKİ MEVCUT DURUMLA İLGİLİ BÜTÜN BİLGİLERİN DOĞRU OLDUĞUNU VE BU FORMDA BELİRTTİĞİM HUSUSLARI YASA VE TÜZÜK HÜKÜMLERİNE GÖRE YERİNE GETİRECEĞİMİ BEYAN EDERİM VE TAAHHÜT EDERİM. I hereby Declare And Certify that All Information Given in this form and its Enclosure is Correct and all particulars will be accomplised in compliance with the Law and the provision of the Requlations. ADI Name GÖREVİ Title TARİH Date (Day/Month/Year) YETKİLİ İMZA Authorised Signature 10
ADRESİ Address KİMLİK/PASAPORT NO. Identity/Passport No TELEFONLAR Phones FAKS Fax 12- EKLER Enclosures 12-1. İMZA SAHİBİNİN YETKİ BELGESİ, İMZA SİRKÜLERİ Power Of Attorney of the signatory 12-2. FİRMA VE BÖLGEDEKİ FAALİYETİ İLE İLGİLİ TANITICI BİLGİ Descriptive Information on the firm and its Operation in the Zone. 12-3. TAMAMLAYICI BİLGİLER Further Information EKLERİN TOPLAM SAYFA ADEDİ... Total Number of Enclosed Sheets... 11