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Unit Entrance Photo Submission Required

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by an individual named Sachin for a food services business in Delhi. It includes details about the applicant, business location, contact information, intended start date, and compliance with food safety regulations. The application also contains declarations regarding the accuracy of the information provided and the applicant's commitment to adhere to food safety standards.

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aarteejyoti148
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52 views2 pages

Unit Entrance Photo Submission Required

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by an individual named Sachin for a food services business in Delhi. It includes details about the applicant, business location, contact information, intended start date, and compliance with food safety regulations. The application also contains declarations regarding the accuracy of the information provided and the applicant's commitment to adhere to food safety standards.

Uploaded by

aarteejyoti148
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

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: 30250317119510134 Application Type: New Registration


Name of Applicant / Sachin 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: 942 gali no 08, State: Delhi


Govindpuri Kalkaji
Sub-Division/Station/ KALKAJI
110019
Division:
District/Region/Zone: South East Pan No: TORPS2822L
Village: TUGLAKABAD Name: SACHIN
Pin Code: 110019 DOB: 01-01-2007
Nearest Landmark: Harman patanjali Gender: MALE
store

Correspondence Address Details

Address: 942 gali no 08, State: Delhi


Govindpuri Kalkaji Sub-Division/Station/ KALKAJI
110019 Division:
District/Region/Zone: South East Pin Code: 110019
Village: TUGLAKABAD

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 9389134587 Email-ID: sachinsachin75737@gm
Contact Person: SACHIN ail.com
Aadhaar No: 91XXXXXXXX12

Other Details

In case of New business – intended date of start: 23-03-2025


Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 1

Page 1 of 2
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 16 - Prepared Foods

Document(s) Details

S.No. Documents Description Uploaded Document


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

Other Document(s) Details

S.No. Documents Description Uploaded Document


1 Photographs of the unit (Entrance/Front facing end of the unit) 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

घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची

Page 2 of 2

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