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: 30251223122680681 Application Type: New Registration
Name of Applicant / Bournonite Application Date: N/A
Company: Kind of Business: Manufacturer -
Designation: Individual General
Manufacturing
Address of Premises Where Food Business Is Located
Address: Indra Vikas State: Delhi
colony ,North
Sub-Division/Station/ SARASWATI VIHAR
phase Mukhrjee
Division(Railways):
Nagar
Pan No: GRXPM4045M
District/Region/Zone: North West
Name: SHREYASH MISHRA
Village: WAZIRPUR
DOB: 01-08-2001
Pin Code: 110009
Gender: MALE
Nearest Landmark: N/A
Correspondence Address Details
Address: Indra Vikas State: Delhi
colony ,North Sub-Division/Station/ SARASWATI VIHAR
phase Mukhrjee Division(Railways):
Nagar
Pin Code: 110009
District/Region/Zone: North West
Village: WAZIRPUR
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 9958052319 Email-ID: N/A
Contact Person: Shreyash Mishra Aadhaar No: 43XXXXXXXX94
Other Details
In case of New business – intended date of start: 24-12-2025
Source of Water Supply: Private
Sanction Electricity Load or HP Used: No
Number of years applied for: 1
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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.]
Manufacturer Unit
[Link]. Food Sub-Food Category Product Kind of
Category Business
1 05 - 05.1 - Cocoa products and chocolate Cocoa mass or Cocoa/ Manufacturer
Confectionery products including imitations and Chocolate Liquor and
chocolate substitutes Cocoa Cake [05.1.1]
2 05 - 05.1 - Cocoa products and chocolate Chocolate [05.1.3] Manufacturer
Confectionery products including imitations and
chocolate substitutes
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
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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