|
সার ব্যবসার জন্য সরকারী অনুমতি পত্রের দরখাস্ত |
|||||||||
|
|
|||||||||
EMBLEM |
|||||||||
FORM "C" |
|||||||||
(See clause 11) |
|||||||||
APPLICATION FOR RENEWAL OF THE CERTIFICATE OF REGISTRATION TO CARRY ON THE BUSINESS OF SELLING FERTILISERS IN RETAIL / WHOLESALE / *FOR INDUSTRIAL USE |
|||||||||
|
|
|||||||||
To, |
|||||||||
The Registering Authority / *Controller ( if application is Industrial dealer's certificate of Registration). |
|||||||||
|
|
|||||||||
Place: |
|||||||||
State: |
|||||||||
|
|
|||||||||
I / we hereby apply for renewal of the certificate of registration to carry on the business of selling fertilisers in retail / wholesale / *for industrial use under the name and style of ......................................................... |
|||||||||
The Certificate of registration desired to be renewed was granted by Registering Authority for the ............. |
|||||||||
............................ (mention place and state) and allotted registration certificate No .................... on the |
|||||||||
........................... day of .................. 20 ............. |
|||||||||
|
|
|||||||||
2. (i) I / we hereby declare that the situation of my / our premises where fertilisers are (a) stored and (b) sold is as stated below: |
|||||||||
|
|
|||||||||
(a) |
(b) |
||||||||
Premises where fertilisers are stored |
Premises where fertilisers are sold |
||||||||
|
|
|||||||||
(ii) I / we hereby declare that the fertiliser(s) in which I / we am / are carrying on the business of selling and the name(s) of manufacturer(s) / importer(s), Commodity Board(s), Saate Govermment(s) and Dealer(s) whom I / we represent are as stated below: |
|||||||||
|
|
|||||||||
(a) |
(b) |
||||||||
Name(s) of fertiliser(s) |
Name(s) of manufacturer(s) / importer(s) Commodity Board(s), wholesale Dealer(s). |
||||||||
|
|
|||||||||
3. I / we enclose a certificate of source from the manufacturer(s), importer(s), Commodity Board(s), State Government(s), wholesale Dealer(s) whom I / we represent or intend to represent and from whom fertiliser(s) will be obtained by me / us. |
|||||||||
|
|
|||||||||
*4. I have deposited the renewal fee of Rs. .................. vide challan No. ........................ dated ............... |
|||||||||
in Treasury / Bank ............................ or I enclose the Demand Draft No. .................... dated ................. |
|||||||||
for Rs. ............................. payable at ........................... towards renewal fee (Please strike out whichever not applicable ). |
|||||||||
|
|
|||||||||
|
|
|||||||||
Full Name and address of the applicant(s) |
Signature of applicant(s) |
||||||||
(in block letters) |
|
||||||||
|
|
|||||||||
Date: |
|||||||||
Place: |
|||||||||
|
|
|||||||||
Certified that the certificate of registration bearing number .......................................granted on ................. |
|||||||||
for the period from ..................................to .............................................to carry on the business of |
|||||||||
selling fertilisers in retails / wholesale / *for Industrial use at the premises situated at ................................. |
|||||||||
is hereby renewed till the ....................... unless previously suspended or cancelled under the provisions of |
|||||||||
the Fertiliser (Control) Order 1985. |
|||||||||
|
|
|||||||||
|
|||||||||
|
|
|||||||||
Date: |
*Controller / Registering Authourity |
||||||||
|
|
|||||||||
Renewal number: |
Place: |
||||||||
Seal |
State: |
||||||||
|
|
|||||||||
|
|
|||||||||
|
|
|||||||||
*Vide S.O.795(E) dt.22.11.91 |
|||||||||
