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: 30260215123379881 Application Type: Renewal
Name of Applicant / SARADA PHARMACY Application Date: N/A
Company: Kind of Business: Trade/Retail - Retailer
Designation: Proprieter Certificate No: 22824085000172
Expiry Date: 15-02-2026
Address of Premises Where Food Business Is Located
Address: VILL- State: West Bengal
BHASTARA,POST-
Sub-Division/Station/ DHANIAKHALI
BHASTARA,DEST-
Division(Railways):
HOOGHLY
Pan No: CQGPD4675N
District/Region/Zone: Hooghly
Name: SANCHITA DAS
Village: BHASTARA
DOB: 10-09-1991
Pin Code: 712303
Gender: Female
Nearest Landmark: NEAR BHASTARA
HIGH SCHOOL
Correspondence Address Details
Address: VILL- State: West Bengal
BHASTARA,POST- Sub-Division/Station/ DHANIAKHALI
BHASTARA,DEST- Division(Railways):
HOOGHLY
Pin Code: 712303
District/Region/Zone: Hooghly
Village: BHASTARA
Contact Details
Telephone No: 9732668275 Fax: N/A
Mobile No: 7318869444 Email-ID: saradapharmacy1963@
Contact Person: ARKAJYOTI DAS [Link]
Other Details
In case of New business – intended date of start: 17-02-2024
Source of Water Supply: N/A
Sanction Electricity Load or HP Used: No
Number of years applied for: 5
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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. Name of the food category
No
1 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
2 01 - Dairy products and analogues, excluding products of food category 2.0
3 04 - Fruits and vegetables (including mushrooms and fungi, roots and tubers, fresh pulses and
legumes, and aloe vera), seaweeds, and nuts and seeds
4 11 - Sweeteners, including honey
Document(s) Details
[Link]. Documents Description Uploaded Document
1 Identity Proof - Aadhar Card View
2 Photo View
Other Document(s) Details
[Link]. Documents Description Uploaded Document
1 Proof of Premises view
2 NOC by Municipality/Panchayat 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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