Scribd
Upload
3 views

Application

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Nagendra Tamboli for a food services business in Bhilwara, Rajasthan. It includes details about the applicant, business type, premises address, food items, and compliance declarations. The applicant intends to operate within the regulations and has provided necessary documentation for the registration process.

Uploaded by

deepak
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
3 views

Application

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Nagendra Tamboli for a food services business in Bhilwara, Rajasthan. It includes details about the applicant, business type, premises address, food items, and compliance declarations. The applicant intends to operate within the regulations and has provided necessary documentation for the registration process.

Uploaded by

deepak
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: 30240302115919774 Application Type: New Registration


Name of Applicant / Nagendra Tamboli Application Date: N/A
Company: Kind of Business: Food Services - Petty
Designation: Individual Retailer of snacks/tea
shops

Address of Premises Where Food Business Is Located

Address: Gol Payu chouraha State: Rajasthan


Opposite Sangam
Sub-Division/Station/ Bhilwara Ward 38
university city
Division(Railways):
office
Pin Code: 311001
District/Region/Zone: Bhilwara
Pan No: N/A
Village: N/A
Nearest Landmark: N/A

Correspondence Address Details

Address: Gol Payu chouraha State: Rajasthan


Opposite Sangam Sub-Division/Station/ Bhilwara Ward 38
university city Division(Railways):
office
Pin Code: 311001
District/Region/Zone: Bhilwara
Village: N/A

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 9799286589 Email-ID: [email protected]
Contact Person: Nagendra Tamboli om

Other Details

In case of New business – intended date of start: N/A


Source of Water Supply: Private
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 16 - Prepared Foods
2 01 - Dairy products and analogues, excluding products of food category 2.0

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


1 Proof of Premises 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

You might also like