Application form for Obtaining License to Sell Milk and Milk Products PART I 1. Name and Address of the applicant. ________________________________________ 2. Names of the Managing Director, Directors, Proprietors, Partners, Owners etc. 3. Address of the business/dairy plant and of all the establishments/premises owned or managed by the applicant. _________________________________________________ 4. Telephone Numbers/Gram/Telex _________________________________________ 5 (a) Description of milk and milk products with quantities per year which the applicant is equipped to handle/control/process/manufacture. (Give full details) ________________________________________________________________ (b) If already handling processing/controlling or manufacturing milk or milk product, the annual quantity of each product in the last three years (Give separately for each year) __________________________________________________ (c) The quantity of each item of milk or milk product proposed to be handled processed or manufactured. _________________________________________ 6. Branches including chilling/collection centers. _______________________________ 7. Installed per day capacity of the dairy plant. _________________________________ 8. Total quantities of milk and each of the mil products handled or processed or controlled during the year.__________________________________________________ 9. Average quantity of milk per day to be used or handled (a) In lean season _________________________________________________________ (b) In flush season ________________________________________________________ PART II DETAILED DESCRIPTION ABOUT COLLECTION OF MILK 1. Geographical area proposed for the milk collection. 2. Number of districts and villages from where the milk will be collected. 3. Number of breed-wise milch cows. buffaloes, sheep or goat. district-wise in the area. 4. District map showing taluka/Tehsil boundaries and major roads/rail roads etc. 5. A brief description about the existing milk procurement, processing and marketing facilities. 6. Milk producers' cooperative societies/union etc -total and functional in the area of operation. 7. Number of dairy plants -public/private in the area of operation. 8. Any other developmental program. 9. Input services provided to the farmers/proposed to be provided for milk production enhancement. I/we hereby undertake to comply with all the provisions of the Milk land Milk Product Order. 1998. Please find forwarded herewith the prescribed registration fee. I/we declare that the facts stated herein above and the particulars given in Parts II and I are true and correct. Place: Signature(s) of the applicant(s) Date:
