Form of Application to obtain dealer licence
Form of Application to obtain dealer licence
Form of Application to obtain dealer licence
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FORM 'A'(See clause 4)FORM OF APPLICATION TO OBTAIN DEALER'S LICENCEToThe Registering Authority,(Place)State <strong>of</strong>1. Full Name and Address <strong>of</strong> the Applicant:(a) Name:Village.Teh.S/O or W/OP.O.DistrictHimachal Pradesh, State,Telephone(b) Place <strong>of</strong> Business (Place give exact address):(i) For Sale: PlaceTeh.District(ii) For S<strong>to</strong>rage: PlaceTeh.District2. Is it a Proprietary/ Partnership/ Limited Company/ Hindu Undivided Family Concern?Give the Name(s) and Address (es) <strong>of</strong> Proprie<strong>to</strong>r/ Partner/ Manager/ Karta.3. In What Capacity this <strong>Application</strong> is Made:(i) Proprie<strong>to</strong>r(ii) Partner(iii) Manager(iv) Karta
4. Was the Applicant ever convicted under the Essential Commodities Act, 1955 (10 <strong>of</strong>1955), or any order issued thereunder during the last three years preceding the date<strong>of</strong> <strong>Application</strong>? If so, give details.5. Give the Details <strong>of</strong> Seeds <strong>to</strong> be handled;S.No.Name <strong>of</strong> Seed6. I/We have deposited the Licence Fee <strong>of</strong> RupeesVide Challan No.DatedIn the Treasury/ Bank7. Declaration:(a) I/We declare that the information given above is true <strong>to</strong> the best <strong>of</strong> my/ ourknowledge and belief and no part there<strong>of</strong> is false.(b) I/We have carefully read the terms and conditions <strong>of</strong> the Licence given in <strong>Form</strong> 'B'appended <strong>to</strong> the Seed (Control) Order, 1983, and agree <strong>to</strong> abide by them.Signature <strong>of</strong> ApplicantDatedName:Place:Note:Where the business <strong>of</strong> selling/ export/ Importing Seeds is intended <strong>to</strong> be Carried on at morethan one place, a separate <strong>licence</strong> should be <strong>obtain</strong>ed for each such place.For use in the <strong>of</strong>fice <strong>of</strong> Licensing AuthorityDate <strong>of</strong> reciptName and designation <strong>of</strong> <strong>of</strong>ficer receiving the application