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: 30241120118211972 Application Type: New Registration
Name of Applicant / DHARMENDRA Application Date: N/A
Company: Kind of Business: Trade/Retail - Retailer
Designation: Individual
Address of Premises Where Food Business Is Located
Address: VPO DHAMETA State: Himachal Pradesh
District/Region/Zone: Kangra Sub-Division/Station/ Indora
Village: N/A Division(Railways):
Pin Code: 176025 Pan No: N/A
Nearest Landmark: PNB DHAMETA
Correspondence Address Details
Address: VPO DHAMETA State: Himachal Pradesh
District/Region/Zone: Kangra Sub-Division/Station/ Indora
Village: N/A Division(Railways):
Pin Code: 176025
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 8351972022 Email-ID: shekharmehra88@gma
Contact Person: DHARMENDRA [Link]
Aadhaar No: 39XXXXXXXX52
Other Details
In case of New business – intended date of start: 20-11-2024
Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 5
Detail(s) of Food Item
[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]
Page 1 of 3
Other than Manufacturer Unit
Sl. No Name of the food category
1 01 - Dairy products and analogues, excluding products of food category 2.0
2 02 - Fats and oils, and fat emulsions
3 03 - Edible ices, including sherbet and sorbe
4 07 - Bakery products
5 10 - Eggs and egg products
6 13 - Foodstuffs intended for particular nutritional uses
7 15 - Ready-to-eat savouries
8 14 - Beverages, excluding dairy products
9 16 - Prepared Foods
10 99 - Substances added to food
11 100 - Standardised Food Product excluding those covered under category 1-14
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 Health NOC 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. 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
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