FORM 'A' J&K STATE KEROSENE DEALERS LICENSING ORDER, 1997 Application for Grant/Renewal of Wholesale/Retail License of Kerosene Oil under the Public Distribution System To The District Magistrate, ________ District. I/We hereby apply for the grant/renewal of a wholesale/retail licence to sell or supply kerosene under the Public Distribution System (here mention address or addresses of the place of business) ________________________________________________________________. 1.Name, Parentage and Postal Address of the Applicant________________ __________________________________________________________________. 2. Address and detail of the location(s) of the applicant's godown _____________ __________________________________________________________________. 3. Period for which licence is required________________________________________ I/We declare that I/We have never been convicted for an offence under the Essential Commodities Act, 1955 (Act No. 10 of 1955) or an order issued there under any State Control Order. I/We hereby declare that all the particulars given on this form are correct. I/We hereby apply for grant/renewal of license No. Dated ______________________ issued to me on ___________________________. Place _____________________ Date _____________________ Signature of the Applicant Note : Strike out whichever is not applicable.
