Responsibility Mark – Responsibility Mark Approval – Assayer-Smelter Name or Firm of the HolderName or Firm of the HolderNIF/NIPC (VAT ID #)NIF/NIPC (VAT ID #)Registered office or place of residence for tax purposes (mandatory filling)AddressAddressPostal CodePostal CodeTown/CityTown/CityParishParishMunicipalityMunicipalityDistrictDistrictPhone/Mobile phonePhone/Mobile phoneEmail addressEmail addressDeclaration of Commencement of ActivityDeclaration of Commencement of ActivityRemove fileCode of the permanent certificateCode of the permanent certificateCertified copy of criminal recordCertified copy of criminal recordIn the case of a legal person, you must attach a criminal record certificate for its administrators, directors or managers.Remove fileAdicionar ficheirosCertified copy of criminal record - 2Certified copy of criminal record - 2Remove fileCertified copy of criminal record - 3Certified copy of criminal record - 3Remove fileCertified copy of criminal record - 4Certified copy of criminal record - 4Remove fileCertified copy of criminal record - 5Certified copy of criminal record - 5Remove fileCertified copy of criminal record - 6Certified copy of criminal record - 6Remove fileLocation where the activity is carried outAddressAddressPostal CodePostal CodeTown/CityTown/CityParishParishDistrictDistrictMunicipalityMunicipalityData of the Technical Manager of Assayer-SmelterNameNameProfessional Title NumberProfessional Title NumberNIF (Taxpayer #)NIF (Taxpayer #)Nationality/Residence StatusNationality/Residence StatusAddress or residence for tax purposesAddress or residence for tax purposesPostal CodePostal CodeTown/CityTown/CityMobile phoneMobile phoneEmail addressEmail addressPlease attach: Criminal Record Certificate of the Technical Manager of Assayer-SmelterPlease attach: Criminal Record Certificate of the Technical Manager of Assayer-SmelterMandatory for the Assayer-Smelter activityRemove fileResponsibility Mark - DesignDid you acquire the responsibility mark in INCM’s online store?YesNoInsert the requested number of the Responsibility Mark acquired at the online storeInsert the requested number of the Responsibility Mark acquired at the online storePlease attach: Design of the Responsibility MarkPlease attach: Design of the Responsibility MarkIn accordance with Article 25 of the RJOC, it must contain a private design and a letter of its name or firm, the design and the letter visibly distinct and enclosed in a peripheral contour. The drawing may not be extracted from the animal kingdom nor liable to confusion with existing ones.Remove fileResponsibility Mark - Support - PunctureDo you want INCM to manufacture the punch (punch + matrix)?YesNoImportant informationIf the manufacture of the material of your responsibility mark is not done by the Assay Office, you must submit it at the reception for approval and registration.Choose punch dimension (subject to approval)Choose punch dimension (subject to approval)Select an option 0.85X0.85mm0.90X0.90mm1.00X1.00mm1.20X1.20mmOther measureResponsibility Mark - Kind - LaserDo you wish the Laser Mark to be created by INCM?YesNoResponsibility Mark number (Puncture No.)Responsibility Mark number (Puncture No.)Attach: Vector file with the laser mark design (if applicable)Attach: Vector file with the laser mark design (if applicable)Remove fileCustomer Data/InvoiceName/CompanyName/CompanyAddressAddressPostal CodePostal CodeTown/CityTown/CityCountryCountrySelect an option AndorraUnited Arab EmiratesAfghanistanAntigua and BarbudaAnguillaAlbanyArmeniaNetherlands AntillesAngolaAntarcticaArgentinaAmerican SamoaAustriaAustraliaArubaAzerbaijanBosnia HerzegovinaBarbadosBangladeshBelgiumBurkina FasoBulgariumBahrainBurundiBeninBlueBermudaBrunei DarussalamBoliviaBrazilBahamasBhutanBouvet IslandsBotswanaBelarusBelizeCanadaCoconut IslandsCongo RepublicCentral African RepublicCongoSwitzerlandIvory CoastCook IslandChileCameroonChinaColombiaCosta RicaSerbia and MontenegroCubaCape VerdeChristmas IslandCyprusCzech republicGermanyDjiboutiDeenmarkDominicaDominican RepublicAlgeriaEcuadorEstoniaEgyptWestern SaharaEritreiaSpainEthiopiaEuropean UnionFinlandFijiFalkland IslandsMicronesiaFaroe IslandsFranceGabonUnited KingdomGrenadaGeorgiaFrench GuianaGhanaGibraltarGreenlandGambiaGuineaGuadeloupeEquatorial GuineaGreeceSouth Georgia and the South Sandwich IslandsGuatemalaGuamGuinea BissauGuyanaHong KongHeard and McDonald IslandsHondurasCroatiaHaitiHungaryIndonesiaIrelandIsraelIndiaBritish Territory in the Indian OceanIraqIranIcelandItalyJerseyJamaicaJordanJapanKenyaKyrgyzstanCambodiaKiribatiComorosSaint Kitts and NevisNorth KoreaSouth KoreaKuwaitCayman IslandsKazakhstanLaosLebanonSaint LuciaLiechtensteinSri LankaLiberiaLesothoLithuaniaLuxembourgLatviaLibyaMoroccoMonacoMoldovaMadagascarMarshall IslandsMacedoniaMaliMyanmarMongoliaMacaoNorthern MarianasMartiniqueMauritaniaMontserratMaltaMauritiusMaldivesMaláwiMexicoMalaysiaMozambiqueNamibiaNew CaledoniaNigerNorfolk IslandNigeriaNicaraguaNetherlandsNorwayNepalNauruNatoNiueNew ZealandOmanAlaranjadoPanamaPeruFrench PolynesianPapua New GuineaPhilippinesPakistanPolandSaint Peter and MiquelonPitcairn IslandPuerto RicoPalestinePortugalPalauParaguayQatarReuniãoRomaniaRussian FederationRwandaSaudi ArabiaSolomon IslandsSeychellesSudanSwedenSingaporeSaint HelenSloveniaSvalbardSlovakiaSierra LeoneSan MarinoSenegalSomaliaSurinameSão Tomé and PríncipeEl SalvadorSyriaSwazilandTurks and Caicos IslandsChadTogoThailandTajikistanTokelau IslandsEast TimorTurkmenistanTunisiaTongaTimor LesteTurkeyTrinidad and TobagoTuvaluTaiwanTanzaniaUkraineUgandaUS Minor IslandsUnited NationsUSAUruguayUzbekistanVaticanSaint Vincent and the GrenadinesVenezuelaVirgin Islands (United Kingdom)US Virgin IslandsVietnamVanuatuWallis and FutunaWestern SamoaYemenMayotteSouth AfricaZambiaZimbabweTaxpayer #Taxpayer #Email addressEmail addressAcceptance of the disclosure of the Responsibility Mark(View conditions)YesNo
