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3 views

Application

application

Uploaded by

ayaanjaved901
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: 30241024117994070 Application Type: New Registration


Name of Applicant / MUMMA'S KITCHEN Application Date: N/A
Company: Kind of Business: Food Services - Food
Designation: Individual Vending Establishment

Address of Premises Where Food Business Is Located

Address: NAITIK VIHAR State: Uttarakhand


PHASE 2,
Sub-Division/Station/ Dehradun Nagar
CHANCHAK ROAD
Division(Railways): Nigam
District/Region/Zone: Dehradun Pan No: CQBPJ3158D
Village: Banjarewala Mafi Name: ALISHA JAVED
Pin Code: 248001 DOB: 14-09-2004
Nearest Landmark: CHANCHAK Gender: FEMALE
CHOWK

Correspondence Address Details

Address: NAITIK VIHAR State: Uttarakhand


PHASE 2, Sub-Division/Station/ Dehradun Nagar
CHANCHAK ROAD Division(Railways): Nigam
District/Region/Zone: Dehradun Pin Code: 248001
Village: Banjarewala Mafi

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 7217245089 Email-ID: ALISHAJAVED721@GM
Contact Person: ALISHA JAVED AIL.COM
Aadhaar No: 75XXXXXXXX46

Other Details

In case of New business – intended date of start: 01-11-2024


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

Detail(s) of Food Item

Page 1 of 2
[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]

Other than Manufacturer Unit


Sl. No Name of the food category
1 02 - Fats and oils, and fat emulsions
2 18- Indian Sweets and Indian Snacks & Savouries products
3 16 - Prepared Foods
4 10 - Eggs and egg products
5 12 - Salts, spices, soups, sauces, salads and protein products

Document(s) Details

S.No. Documents Description Uploaded Document


1 Photo View
2 Identity Proof - Aadhar Card View

Other Document(s) Details

S.No. Documents Description Uploaded Document


No Record Found

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. Penalty 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 liable to penalty which may extend to ten 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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