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: 30251027121959034 Application Type: New Registration
Name of Applicant / BreadBar Application Date: N/A
Company: Kind of Business: Food Services -
Designation: Individual Restaurants
Address of Premises Where Food Business Is Located
Address: Second floor, G - State: Punjab
Tower, Flat no.
Sub-Division/Station/ SAS Nagar Mohali-2
203, Awho Flat,
Division(Railways): (Teshil Mohali, P/S
Harbhajan Vihar,
Sohana)
Sector 114,
Sahibzada Ajit Pan No: BMZPT7463A
Singh Nagar Name: NIKHIL TYAGI
District/Region/Zone: Mohali DOB: 28-05-2000
Village: Mohali Gender: MALE
Pin Code: 140307
Nearest Landmark: Near by Harbhajan
Vihar
Correspondence Address Details
Address: Second floor, G - State: Punjab
Tower, Flat no. Sub-Division/Station/ SAS Nagar Mohali-2
203, Awho Flat, Division(Railways): (Teshil Mohali, P/S
Harbhajan Vihar, Sohana)
Sector 114,
Pin Code: 140307
Sahibzada Ajit
Singh Nagar
District/Region/Zone: Mohali
Village: Mohali
Contact Details
Telephone No: 7087897636 Fax: N/A
Mobile No: 7011763658 Email-ID: nikhiltyagi7011@gmail
Contact Person: Nikhil Tyagi .com
Aadhaar No: 45XXXXXXXX33
Other Details
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In case of New business – intended date of start: 01-11-2025
Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 2
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
Document(s) Details
[Link]. Documents Description Uploaded Document
1 Photo View
2 Identity Proof - Driving License View
Other Document(s) Details
[Link]. Documents Description Uploaded Document
No Record Found
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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