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: 30251230122777536 Application Type: New Registration
Name of Applicant / SK BABLU Application Date: N/A
Company: Kind of Business: Food Services - Club/
Designation: Individual Canteen
Address of Premises Where Food Business Is Located
Address: INDA RABINDRA State: West Bengal
PALLY
Sub-Division/Station/ KHARAGPUR
KHARAGPUR
Division(Railways): MUNICIPALITY
District/Region/Zone: Paschim Mednipur Pan No: BAMPB6276N
Village: WARD NO-2 Name: SEKH BABLU
Pin Code: 721305 DOB: 21-10-1980
Nearest Landmark: PAYEL LODGE Gender: MALE
Correspondence Address Details
Address: INDA RABINDRA State: West Bengal
PALLY Sub-Division/Station/ KHARAGPUR
KHARAGPUR Division(Railways): MUNICIPALITY
District/Region/Zone: Paschim Mednipur Pin Code: 721305
Village: WARD NO-2
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 9382919665 Email-ID: babludecorator665@g
Contact Person: SK BABLU [Link]
Other Details
In case of New business – intended date of start: N/A
Source of Water Supply: Private
Sanction Electricity Load or HP Used: No
Number of years applied for: 1
Detail(s) of Food Item
[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]
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Other than Manufacturer Unit
Sl. Name of the food category
No
1 01 - Dairy products and analogues, excluding products of food category 2.0
2 02 - Fats and oils, and fat emulsions
3 03 - Edible ices, including sherbet and sorbe
4 04 - Fruits and vegetables (including mushrooms and fungi, roots and tubers, fresh pulses and
legumes, and aloe vera), seaweeds, and nuts and seeds
5 05 - Confectionery
6 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
7 07 - Bakery products
8 08 - Meat and meat products, including poultry and game
9 09 - Fish and fish products, including molluscs, crustaceans, and echinoderms
10 10 - Eggs and egg products
11 11 - Sweeteners, including honey
12 12 - Salts, spices, soups, sauces, salads and protein products
13 13 - Foodstuffs intended for particular nutritional uses
14 14 - Beverages, excluding dairy products
15 18- Indian Sweets and Indian Snacks & Savouries products
16 99 - Substances added to food
17 100 - Standardised Food Product excluding those covered under category 1-14
Document(s) Details
[Link]. Documents Description Uploaded Document
1 Photo View
2 Identity Proof - Pan Card View
Other Document(s) Details
[Link]. Documents Description Uploaded Document
1 Proof of Premises view
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,
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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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