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Application

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Aniruddha Laxman Naiknaware for his food services business, Bapus Tea House, located in Aurangabad, Maharashtra. The application includes details such as the business type, intended start date, contact information, and supporting documents. Aniruddha affirms compliance with food safety regulations and declares that the information provided is accurate.

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sushilshinde1683
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0 views

Application

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Aniruddha Laxman Naiknaware for his food services business, Bapus Tea House, located in Aurangabad, Maharashtra. The application includes details such as the business type, intended start date, contact information, and supporting documents. Aniruddha affirms compliance with food safety regulations and declares that the information provided is accurate.

Uploaded by

sushilshinde1683
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/ 3

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: 30250326119621878 Application Type: New Registration


Name of Applicant / ANIRUDDHA Application Date: 26-03-2025
Company: LAXMAN Kind of Business: Food Services - Petty
NAIKNAVARE / Retailer of snacks/tea
BAPUS TEA HOUSE shops
Designation: Individual

Address of Premises Where Food Business Is Located

Address: C-166, MIDC State: Maharashtra


WALUJ,
Sub-Division/Station/ Aurangabad Taluka
AURANGABAD
Division(Railways):
District/Region/Zone: Aurangabad Pan No: BEMPN7174P
Village: Pandharpur Name: ANIRUDDHA LAXMAN
Pin Code: 431136 NAIKNAVARE
Nearest Landmark: N/A DOB: 16-06-1994
Gender: MALE

Correspondence Address Details

Address: C-166, MIDC State: Maharashtra


WALUJ, Sub-Division/Station/ Aurangabad Taluka
AURANGABAD Division(Railways):
District/Region/Zone: Aurangabad Pin Code: 431136
Village: Pandharpur

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 7276290572 Email-ID: naiknwarepatil@gmail
Contact Person: 7276290572 .com
Aadhaar No: 62XXXXXXXX73

Other Details

In case of New business – intended date of start: 26-03-2025


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

Page 1 of 3
Detail(s) of Food Item

[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 15 - Ready-to-eat savouries

Document(s) Details

S.No. Documents Description Uploaded Document


1 Photo - Pan Card View
2 Identity Proof - Aadhar Card View

Other Document(s) Details

S.No. Documents Description Uploaded Document


1 Proof of Premises view
2 declaration for food license view
3 udyam aadhar view
4 pan card view

S.No. Mode Of Payment Payment Date Transcation Number Razorpay ID Amount


1 Razorpay 26-03-2025 375297996345850 pay_QBPZLS8Pj6hYer 500.00

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

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घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची

Date & Time : 26-03-2025 17:30:22 IST


Applicant Name : ANIRUDDHA LAXMAN NAIKNAVARE / BAPUS TEA HOUSE
Verified through Mobile : 72XXXXXX72
IP Address : 223.185.42.2

Page 3 of 3

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