Application for grant/renewal of License of Registration of Edible Oils Packets under the Edible Oils Packaging (Regulation) Order, 1998 for the period commencing from______________ to ____________ 1. Name and address of the applicant or registered packer : 2. Address of the factory : i. No. _____ ( In case there is no premises no., the boundaries of site shall be noted) ii. Municipality/Notified area/Town area/Railway area/village _________________ iii. District________________ 3. No. _____________ and dated ______________ ( No. of certificate of registration, if any, already granted under this order). 4. Description of the edible oils and fats* (i) (ii) (iii) * Insert the name and nature of edible oils and fats for which application is made for grant or renewal of certificate of registration. 5. Period for which certificate of registration is required: 6. Details of the equipments installed for packing of edible oils and fats (Use a separate sheet (i) if required) (ii) (iii) 7. Details of laboratory testing facilities installed or arrangements made for testing of edible oils and fats as required under sub-clause(3) of clause of this order: (i) (ii) (iii) 8. I / We hereby undertake to comply with all the provisions of the Edible Oils Packaging (Regulation) Order, 1998. 9. I / we have forwarded requisite fee in respect of grant / renewal of certificate of registration to the registering authority in the manner as specified by the Jammu and Kashmir Government. Dated: (Signature of the applicant/registered packer) Note: Please strike out which is not applicable.