FORM-A [See Clause 4(1) (a)] APPLICATION FORM FOR GRANT OF TRADE ARTICLE LICENCE To The Licensing Authority .................... Sir, I hereby apply for the grant of License under the Himachal Pradesh Trade Articles (Licensing and Control) Order, 1981. The required particulars are given hereunder: 1. Applicant's particulars: NAME ........... S/O ........... AGE ... Caste ...... Residential address of applicant: (a) House No. .......... (b) Mohalla ........ (c) Village/town ........ (d) Tehsil ......... 2. Name/style in which License is required ............ 3. Situation of applicant's place of business............. (a) House No. ....... (b) Mohalla ........ (c) Village/town ...... (d) Tehsil ......... 4. Name of partners, if any of the firm: (a) Shri........... S/o........... Age..... Caste ....... (b) Shri........... S/o........... Age...... Caste ....... (c) Shri........... S/o........... Age..... Caste ....... 5. Particulars of trade articles in which the applicant wants to carry on business: 1...................... 2...................... 3....................... 6. Did the applicant previously hold a License of the trade articles for which License has now been applied? If so, give details: (i) Name of the articles ........................... (ii) License No............. (iii) Amount of security deposited with challan No. and date.......... 7. Does the applicant want to get the security mentioned at item No. 7 above adjusted towards Security of the License now applied for, if so, give its challan No......date....and amount.... 8. How long has the applicant been trading in the trade articles for which the License has been applied? 9. Particulars regarding stocks of trade articles in possession on the date of application. 10. Complete, address (with house No. Mohalla etc. of godowns or place where trade articles for which license has been applied will be stored: 1...................... 2...................... 3....................... 4....................... 11. Has the applicant ever been convicted by a Court of law for contravention of any order issued under Essential Commodities Act, 1955 during that 3 years? 12. Particulars of suspension or cancellation of the license held by the applicant during last 3 years. 13. Wherever the applicant was declared or adjudged as an insolvent by a Court? 14. Whether the applicant is a lunatic or of unsound mind. I........declare that the particulars mentioned at item No. 1 to 15 above are true to the best of my knowledge and belief and nothing has been concealed therein. I have carefully read the provisions of the HP Trade Articles (Licensing & Control) Order, 1981 and I agree to abide by them. Place....... ................... Signature of Proprietor/Partner Date....... Downloaded from http://hpfood.nic.in Page 1 of 1
