Food Safety Compliance System (FoSCoS)
[Link]
Form A
[See Regulation 2.1.1, Regulation 2.1.7]
Application for Registration under food safety and Standards Act,2006
Application No: 30240221115828883 Application Type: Renewal
Name of Applicant / Bamadevi Suthakar / Application Date: 21-02-2024
Company: S P Medicals Kind of Business: Trade/Retail - Retailer
Designation: Proprieter Certificate No: 22422288000014
Expiry Date: 21-02-2025
Address of Premises Where Food Business Is Located
Address: No.12 Udangudi State: Tamil Nadu
Road, Tisaiyanvilai
Sub-Division/Station/ Radhapuram block
District/Region/Zone: Tirunelveli Division(Railways):
Village: N/A Pin Code: 627657
Nearest Landmark: N/A Pan No: N/A
Correspondence Address Details
Address: W/o. Suthakar, State: Tamil Nadu
6/29 Vasagasalai Sub-Division/Station/ Radhapuram block
Street, Tisaiyanvilai Division(Railways):
District/Region/Zone: Tirunelveli Pin Code: 627657
Village: N/A
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 8682849002 Email-ID: N/A
Contact Person: Bamadevi
Other Details
In case of New business – intended date of start: N/A
Source of Water Supply: N/A
Sanction Electricity Load or HP Used: No
Number of years applied for: 1
Detail(s) of Food Item
[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]
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Other than Manufacturer Unit
Sl. Name of the food category
No
1 07 - Bakery products
2 05 - Confectionery
3 11 - Sweeteners, including honey
4 13 - Foodstuffs intended for particular nutritional uses
5 06 - Cereals and cereal products, derived from cereal grains, from roots and tubers, pulses, legumes
and pith or soft core of palm tree, excluding bakery wares of food category 7.0
6 12 - Salts, spices, soups, sauces, salads and protein products
Document(s) Details
[Link]. Documents Description Uploaded Document
1 Photo View
2 Identity Proof - Aadhar Card View
Other Document(s) Details
[Link]. Documents Description Uploaded Document
1 self declaration view
2 self view
[Link]. Mode Of Payment Payment Date Transcation Number Razorpay ID Amount
1 Razorpay 21-02-2024 233665223055670 pay_NdVl9rCxVKP8ST 100.00
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. 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
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घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची
Date & Time : N/A
Applicant Name : Bamadevi Suthakar / S P Medicals
Verified through Mobile :
IP Address :
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