সার ব্যবসার জন্য সরকারী অনুমতিপত্রের দরখাস্ত

FORM "A"

FORM OF APPLICATION TO OBTAIN DEALER'S (INDUSTRIAL)

CERTIFICATE OF REGISTRATION

To,

The ^1*Controller (If the application is for industrial dealer's certificate of registration)

Place............................................... State of ......................................................

1. Full name and address of the applicant :

(a) Name of the concern, and postal address :

(b) Place of business (Please give exact address) :

(i) for sale

(ii) for storage

2. Is it a proprietory / partnership/ limited company/ Hindu Undivided family concern? Give the name(s) and address(es) of proprietor/ partners/ manager/ Karta:

3. In what capacity is this application filed:

(i) Proprietor

(ii) Partner

(iii) Manager

(iv) Karta

4. Whether the application is for wholesale or retail or ²*industrial dealership?

5. Have you ever had a fertiliser dealership registration certificate in the past?

If so, give the following details :

(i) Registration number

(ii) Place for which granted

(iii) whether wholesale or retail or ²*industrial dealership.

(iv) Date of grant of registration certificate

(v) Whether the registration certificate is still valid?

(vi) If not when expired?

(vii) Reasons for non-renewal

(viii) If suspended / cancelled and if so, when

(ix) Quantity of fertilisers handled during last year

(x) Name of the products handled

(xi) Name of the source of supply of fertilisers.

6. Was the applicant ever convicted under the Essential Commodities Act, 1955 or any Order issued thereunder including the Fertiliser (Control) Order, 1957 during the last three years preeciding the date application? If so give details.

7. Give the details of the fertilisers to be handled

Sl. No. Name of Fertiliser Source of supply

8. Please attach certificarte(s) of source from the supplier(s) indicated under column 3 of Sl. No.7.

9. I have deposited the registration fee of Rs................................ vide Challan No....................

dated............................. in treasury / Bank ²*or enclose the Demand Draft No...........................

dated.............................. for Rs........................... drawn on ............................. bank, in favour of

.................................. payable at ..................................................................... towards registration fee. (Please strick-out whichever is not applicable).

10. Declaration:-

(a) I / we declare that the information given above is true to the best of my / our knowledge and belief and no part thereof is false.

(b) I / we have carefully read the terms and conditions of the Certificate of Registration given in Form 'B' appended to the Fertiliser (Control) Order, 1985 and agree to abide by them.

²*(c) I / we declare that I /we do not possess a certificate of registration for industrial dealer and that I / we shall fertilisers for industrial use. (Applicable in case a person intends to obtain a wholesale dealer or retail dealer certificate of registration, excepting a State Government, a manufacturer or importer or a pool handling agency).

²*(d) I / we declare that I / we do not possess a certificate of registration for wholesale dealer or retail dealer and that I / we shall not sell fertilisers for agricultural use. (Applicable in case a person intends to obtain a industrial dealer certificate of registration, expecting a State Government, a manufacturer, importer or a pool handling agency).

Note:

(1) where the business of selling fertilisers is to be carried on at more than one place, a separate application should be made for registration in respect of each such place.

(2) Where a person intends to carry on the business of selling fertilisers both in retail and wholesale, separate applications for retail and wholesale business should be made.

(3) Where a person represents or represent more than one State Government, Commodity Board, Manufacturer /Importer or Wholesale dealer, separate certificate of source from each such source should be enclosed.

FORM "A"

FORM OF APPLICATION TO OBTAIN DEALER'S (INDUSTRIAL)

CERTIFICATE OF REGISTRATION

To,

The 1*Controller (If the application is for industrial dealer's certificate of registration)

Place............................................... State of ......................................................

1. Full name and address of the applicant :

(a) Name of the concern, and postal address :

(b) Place of business (Please give exact address) :

(i) for sale

(ii) for storage

2. Is it a proprietory / partnership/ limited company/ Hindu Undivided family concern? Give the name(s) and address(es) of proprietor/ partners/ manager/ Karta:

3. In what capacity is this application filed:

(i) Proprietor

(ii) Partner

(iii) Manager

(iv) Karta

4. Whether the application is for wholesale or retail or 2*industrial dealership?

5. Have you ever had a fertiliser dealership registration certificate in the past?

If so, give the following details :

(i) Registration number

(ii) Place for which granted

(iii) whether wholesale or retail or 2*industrial dealership.

(iv) Date of grant of registration certificate

(v) Whether the registration certificate is still valid?

(vi) If not when expired?

(vii) Reasons for non-renewal

(viii) If suspended / cancelled and if so, when

(ix) Quantity of fertilisers handled during last year

(x) Name of the products handled

(xi) Name of the source of supply of fertilisers.

6. Was the applicant ever convicted under the Essential Commodities Act, 1955 or any Order issued thereunder including the Fertiliser (Control) Order, 1957 during the last three years preeciding the date application? If so give details.

7. Give the details of the fertilisers to be handled

Sl. No. Name of Fertiliser Source of supply

8. Please attach certificarte(s) of source from the supplier(s) indicated under column 3 of Sl. No.7.

9. I have deposited the registration fee of Rs................................ vide Challan No....................

dated............................. in treasury / Bank 2*or enclose the Demand Draft No...........................

dated.............................. for Rs........................... drawn on ............................. bank, in favour of

.................................. payable at ..................................................................... towards registration fee. (Please strick-out whichever is not applicable).

10. Declaration:-

(a) I / we declare that the information given above is true to the best of my / our knowledge and belief and no part thereof is false.

(b) I / we have carefully read the terms and conditions of the Certificate of Registration given in Form 'B' appended to the Fertiliser (Control) Order, 1985 and agree to abide by them.

Date:

Place: Signature of the Applicant(s)

Note:

(1) where the business of selling fertilisers is to be carried on at more than one place, a separate application should be made for registration in respect of each such place.

(2) Where a person intends to carry on the business of selling fertilisers both in retail and wholesale, separate applications for retail and wholesale business should be made.

(3) Where a person represents or represent more than one State Government, Commodity Board, Manufacturer /Importer or Wholesale dealer, separate certificate of source from each such source should be enclosed.

For use in Office of 1*Controller

Date of receipt:

Name and designation of Officer

receiving the Application

1*-Vide S.O. 49(E)dt.16.01.03

2*-Vide S.O. 795 (E)dt.22.11.91

The ^1*Controller (If the application is for industrial dealer's certificate of registration)

4. Whether the application is for wholesale or retail or ²*industrial dealership?

(iii) whether wholesale or retail or ²*industrial dealership.

dated............................. in treasury / Bank ²*or enclose the Demand Draft No...........................

For use in Office of ¹*Controller