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: 30250601120263000 Application Type: New Registration
Name of Applicant / Harender Application Date: 01-06-2025
Company: Kind of Business: Food Services - Hawker
Designation: Individual (Itinerant / Mobile
food vendor)
Address of Premises Where Food Business Is Located
Address: MEHTA ECLAVE State: Delhi
CHOWK SHIV
Sub-Division/Station/ DWARKA
VIHAR NEAR
Division(Railways):
PEEPAL
Pan No: N/A
District/Region/Zone: South West
Village: BINDA PUR
Pin Code: 110059
Nearest Landmark: Shiv vihar
Correspondence Address Details
Address: MEHTA ECLAVE State: Delhi
CHOWK SHIV Sub-Division/Station/ DWARKA
VIHAR NEAR Division(Railways):
PEEPAL
Pin Code: 110059
District/Region/Zone: South West
Village: BINDA PUR
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 8448819453 Email-ID: harender.diwakar786
Contact Person: Harender @[Link]
Other Details
In case of New business – intended date of start: 01-06-2025
Source of Water Supply: Public
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. No Name of the food category
1 16 - Prepared Foods
2 15 - Ready-to-eat savouries
Document(s) Details
[Link]. Documents Description Uploaded Document
1 Photo - Pan Card View
2 Identity Proof - Pan Card View
Other Document(s) Details
[Link]. Documents Description Uploaded Document
1 Photographs of the unit (Entrance/Front facing end of the unit) view
[Link]. Mode Of Payment Payment Date Transcation Number Amount
1 Fee waived off - Hawker category 01-06-2025 N/A 500.00
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
Date & Time : 01-06-2025 20:23:17 IST
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Applicant Name : Harender
Verified through Mobile : 84XXXXXX53
IP Address : [Link]
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