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Application

The application provides details about the applicant such as name, address, contact information, intended start date of business, source of water supply, electricity load, and requested validity period of 5 years. It also lists food items to be sold, which includes fats and oils, and uploads identity documents like Aadhar card and Pan card. The applicant declares understanding and compliance with relevant provisions of the Act.

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saminashaikh.sfs
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50 views

Application

The application provides details about the applicant such as name, address, contact information, intended start date of business, source of water supply, electricity load, and requested validity period of 5 years. It also lists food items to be sold, which includes fats and oils, and uploads identity documents like Aadhar card and Pan card. The applicant declares understanding and compliance with relevant provisions of the Act.

Uploaded by

saminashaikh.sfs
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Food Safety Compliance System (FoSCoS)

https://foscos.fssai.gov.in
Form A
[See Regulation 2.1.1, Regulation 2.1.7]

Application for Registration under food safety and Standards Act,2006

Application No: 30230824114243629 Application Type: New Registration


Name of Applicant / THE MOMO POINT Application Date: N/A
Company: Kind of Business: Food Services - Petty
Designation: Partner Retailer of snacks/tea
shops

Address of Premises Where Food Business Is Located

Address: NARHE ROAD State: Maharashtra


KASHIBAI NAVALE
Sub-Division/Station/ Sinhgad Road
HOSPITAL
Division(Railways):
District/Region/Zone: Pune Pin Code: 411041
Village: N/A Pan No: N/A
Nearest Landmark: KASHIBAI NAVALE
HOSPITAL

Correspondence Address Details

Address: NARHE ROAD State: Maharashtra


KASHIBAI NAVALE Sub-Division/Station/ Sinhgad Road
HOSPITAL Division(Railways):
District/Region/Zone: Pune Pin Code: 411041
Village: N/A

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 9665932132 Email-ID: [email protected]
Contact Person: SANDIP MOHITE

Other Details

In case of New business – intended date of start: 24-08-2023


Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 5

Detail(s) of Food Item

[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]

Page 1 of 2
Other then Manufacturer Unit
Sl. No Name of the food category
1 02 - Fats and oils, and fat emulsions

Document(s) Details

S.No. Documents Description Uploaded Document


1 Identity Proof - Pan Card View
2 Photo View

Other Document(s) Details

S.No. Documents Description Uploaded Document


1 AADHAR CARD view
2 PANCARD view

I/We declare that:


I/We have read,understood and shall abide all provisions of FSS Act,2006 and Rules, Regulations made
therein and orders issued from time to time applicable to declared food business.
I/We assure that articles of food mentioned in form satisfy the requirements of FSS Act 2006, Rules and
Regulations made thereunder.
I/We shall comply with the general hygiene and sanitary requirements as mentioned in the Schedule 4 of
the FSS (Licensing and Registration of Food Businesses) Regulations, 2011.
Expected Annual turnover of the food business is under Rs.12 Lacs. I will apply for License as and when
annual turnover of food businesses exceeds Rs. 12 Lacs.
I have read/understood the punishment provision under Section 61 of FOOD SAFETY AND STANDARDS ACT,
2006."61. Punishment for false information. If a person, in connection with a requirement or direction under
this Act, provides any information or produces any document that the person knows is false or misleading,
he shall be punishable with imprisonment for a term which may extend to three months and also with fine
which may extend to two lakh rupees"

I do hereby solemnly affirm and declare that all information and particulars furnished here by me are true and
correct to the best of my knowledge.

Declaration || Condition of License || Inspection Checklist

घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची

Page 2 of 2

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