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: 30250616120406954 Application Type: Modification
Name of Applicant / SHAIKH YUNUSBHAI Application Date: 16-06-2025
Company: SHABBIR/SANIA Kind of Business: Food Services - Hawker
CHIKEN AND (Itinerant / Mobile
MUTTON SHOP food vendor)
Designation: Individual Certificate No: 20725031003304
Expiry Date: 15-06-2026
Address of Premises Where Food Business Is Located
Address: OB 1,GANESH State: Gujarat
NAGAR,UMARWAD
Sub-Division/Station/ Surat City
A
Division(Railways):
District/Region/Zone: Surat Municipal Pan No: N/A
Corporation
Village: Surat City
Pin Code: 395010
Nearest Landmark: NR BOMBAY
MARKET
Correspondence Address Details
Address: OB 1,GANESH State: Gujarat
NAGAR,UMARWAD Sub-Division/Station/ Surat City
A Division(Railways):
District/Region/Zone: Surat Municipal Pin Code: 395010
Corporation
Village: Surat City
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 9558258573 Email-ID: yocharan@[Link]
Contact Person: YUNUSH SHAIKH
Other Details
In case of New business – intended date of start: 16-06-2025
Source of Water Supply: N/A
Sanction Electricity Load or HP Used: No
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Number of years applied for: 1
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 15 - Ready-to-eat savouries
2 08 - Meat and meat products, including poultry and game
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 16-06-2025 1965686927176635 pay_QhpbWUEloOWXnu 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.
Declaration || Condition of License || Inspection Checklist
घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची
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Date & Time : 20-06-2025 14:30:28 IST
Applicant Name : SHAIKH YUNUSBHAI SHABBIR/SANIA CHIKEN AND MUTTON
SHOP
Verified through 95XXXXXX73
Mobile :
IP Address : [Link]
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