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: 30241114118156626 Application Type: Modification
Name of Applicant / Dhanashri Ganesh Application Date: 14-11-2024
Company: Narke Kind of Business: Trade/Retail - Retailer
Designation: Individual Certificate No: 21524083006137
Expiry Date: 11-09-2029
Address of Premises Where Food Business Is Located
Address: Dnyaneshwar State: Maharashtra
nagar
Sub-Division/Station/ Mawal
District/Region/Zone: Pune Division(Railways):
Village: Talegaon Dabhade Pan No: BWIPN8667D
(R) Name: DHANASHRI GANESH
Pin Code: 412208 NARKE
Nearest Landmark: talegaon dhabade DOB: 29-10-1995
Gender: FEMALE
Correspondence Address Details
Address: Dnyaneshwar State: Maharashtra
nagar Sub-Division/Station/ Mawal
District/Region/Zone: Pune Division(Railways):
Village: Talegaon Dabhade Pin Code: 412208
(R)
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 9322072064 Email-ID: N/A
Contact Person: 9322072064 Aadhaar No: 59XXXXXXXX96
Other Details
In case of New business – intended date of start: 14-11-2024
Source of Water Supply: N/A
Sanction Electricity Load or HP Used: No
Number of years applied for: 5
Detail(s) of Food Item
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[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 01 - Dairy products and analogues, excluding products of food category 2.0
2 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
3 12 - Salts, spices, soups, sauces, salads and protein products
4 13 - Foodstuffs intended for particular nutritional uses
5 14 - Beverages, excluding dairy products
6 15 - Ready-to-eat savouries
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
No Record Found
[Link]. Mode Of Payment Payment Date Transcation Number Razorpay ID Amount
1 Razorpay 14-11-2024 809824849993425 pay_PLDPN6YjjqhH4I 100.00
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.
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Declaration || Condition of License || Inspection Checklist
घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची
Date & Time : 14-11-2024 19:46:24 IST
Applicant Name : Dhanashri Ganesh Narke
Verified through Mobile : 93XXXXXX64
IP Address : [Link]
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