Food Safety Compliance System (FoSCoS)
[Link]
Form B
[See Regulation 2.1.2, Regulation 2.1.3, Regulation 2.1.7]
Application for Licenses / Renewal of license under food safety and Standards
Act,2006
Application Reference No: 20250913107732957 Application Type: Renewal
Name of Company/ BIMLA TRADERS / Application Date: 13-09-2025
Organizations: SHIVAM BANSAL Kind of Business: Trade/Retail - Retailer
Address: 217/1-A GST No: 09BXYPB3738A1ZD
PANCHSHEEL
CIN No: Not provided
COLONY, ZONE- 7,
Meerut, Uttar Port Name: N/A
Pradesh-250002 License No: 12722051000840
PAN No: BXYPB3738A Expiry Date: 13-09-2026
Registered Office Detail(s)
Address: 217/1-A State: Uttar Pradesh
PANCHSHEEL Pin Code: 250002
COLONY
District : Meerut
Address of Premises for which license is applied
Address: 217/1-A State: Uttar Pradesh
PANCHSHEEL Pin Code: 250002
COLONY
District : Meerut
Sub-Division : ZONE- 7
Correspondence Address
Address: 217/1-A State: Uttar Pradesh
PANCHSHEEL Pin Code: 250002
COLONY
District : Meerut
Contact Information
Telephone No: N/A Fax: N/A
Mobile No: 9870915255 Email-ID: offosbds@[Link]
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Person in charge of operations
Name: SHIVAM BANSAL Qualification: B. TECH
Contact No: N/A Mobile No: 9870915255
Email-ID: offosbds@gmail.c Address: 217/1-A PANCHSHEEL
om COLONY
State: Uttar Pradesh District: Meerut
Pin Code: 250002 Photo Id Card: Aadhar Card
Photo ID No: 242404524271 Photo ID Expiry Date: N/A
FoSTaC No: N/A
Trainee Name: N/A
FoSTac Validity End Date: N/A
Person responsible for complying with conditions of License (The person must be same as mentioned
in Form IX, as per FSS Regulations, 2011)
Name: SHIVAM BANSAL Qualification: B. TECH
Contact No: N/A Mobile No: 9870915255
Email-ID: offosbds@gmail.c Address: 217/1-A PANCHSHEEL
om COLONY
State: Uttar Pradesh District: Meerut
Pin Code: 250002 Photo Id Card: Aadhar Card
Photo ID No: 242404524271 Photo ID Expiry Date: N/A
Number of years applied for: 1
Kind Of Business: Trade/Retail - Retailer
[Link]. Food Product Category
1 05 - Confectionery
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
Other Detail(s)
Whether Unit is Equipped with an analytical laboratory ? :No
Already Holding License: No
Other License: No
Is Holding PA/NOC: No
Document(s) Details
[Link]. Documents Submission Document Uploaded/
Type FBO Remarks
1 Declare the compliance as per inspection checklist [Read Mandatory view
Inspection Checklists in other languages] *
Other Document(s) Details
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[Link]. Documents Description Document Uploaded/FBO Remarks
N/A
Payment Details
[Link]. Mode Of Payment Payment Date Transcation Number Razorpay ID Amount
1 Razorpay 13-09-2025 933278174516498 pay_RH6JnRyQ1aLaVO 2000.00
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 have food safety plan to ensure that articles of food mentioned in form satisfy the requirements of FSS
Act 2006 and Rules and Regulations made thereunder.
Our facility 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.
I/We shall abide with all conditions of License.
Expected capacity of the business is to the best of my knowledge. I/We will modify our License as and when
our eligibility in the mentioned criteria for License changes.
I will be responsible for Permissions/No Objection Certificates from other Govt. bodies wherever required.
I/We have complied with all the permissions/rules, which are applicable to my food business and the
premises of the food business such as CGWA NOC etc.
I/We do not possess more than one active license/ registration for any other food business(es) at the same
premises.
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 : 13-09-2025 18:48:07 IST
Applicant Name : BIMLA TRADERS / SHIVAM BANSAL
Verified through Mobile : 89XXXXXX26
IP Address : [Link]
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