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Food Safety Registration Application Form

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Fahmeeda Begum for a food services business at a location in Jammu & Kashmir. It includes personal and business details, declaration of compliance with food safety regulations, and an assurance of the accuracy of the provided information. The applicant intends to operate within the annual turnover limit of Rs. 12 Lacs and acknowledges the penalties for providing false information.

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9 views2 pages

Food Safety Registration Application Form

The document is an application for registration under the Food Safety and Standards Act, 2006, submitted by Fahmeeda Begum for a food services business at a location in Jammu & Kashmir. It includes personal and business details, declaration of compliance with food safety regulations, and an assurance of the accuracy of the provided information. The applicant intends to operate within the annual turnover limit of Rs. 12 Lacs and acknowledges the penalties for providing false information.

Uploaded by

malikmudasir198
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

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: 30251204122427908 Application Type: New Registration


Name of Applicant / FAHMEEDA BEGUM Application Date: N/A
Company: Kind of Business: Food Services -
Designation: Individual Anganwadi [ICDS]
Centres

Address of Premises Where Food Business Is Located

Address: TARATHPORA State: Jammu & Kashmir


RAMHAL
Sub-Division/Station/ Villagam
KUPWARA
Division(Railways):
District/Region/Zone: Kupwara Pan No: IKBPB2434J
Village: Tarthpora A Name: FAMIDA BEGUM
Pin Code: 193224 DOB: 01-01-1973
Nearest Landmark: N/A Gender: FEMALE

Correspondence Address Details

Address: TARATHPORA State: Jammu & Kashmir


RAMHAL Sub-Division/Station/ Villagam
KUPWARA Division(Railways):
District/Region/Zone: Kupwara Pin Code: 193224
Village: Tarthpora A

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 9622426012 Email-ID: N/A
Contact Person: FAHMEEDA Aadhaar No: 24XXXXXXXX45
BEGUM

Other Details

In case of New business – intended date of start: N/A


Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 5

Detail(s) of Food Item

Page 1 of 2
[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 13 - Foodstuffs intended for particular nutritional uses

Document(s) Details

[Link]. Documents Description Uploaded Document

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

Page 2 of 2

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