Form C Clause 11 Application For Renewal Of The Certificate Of Registration printable pdf download

Form C Clause 11 Application For Renewal Of The Certificate Of Registration

FORM ‘C’

(Clause 11)

APPLICATION FOR RENEWAL OF THE CERTIFICATE OF REGISTRATION TO

CARRY ON THE BUSINESS OF SELLING FERTILIZERS IN RETAIL

/WHOLESALE/*FOR INDUSTRIAL USE

The Registering Authority/*Controller (if the application is for industrial dealers’ certificate

of Registration).

Place :

State :

I/we hereby apply for renewal of the certificate of registration to carry on the business of

selling fertilizers in retail/Wholesale/*for industrial use under the name and style of

............................................................................................. The Certificate of registration

desired

renewed

was

granted

Registering

Authority

for

the

.....................................(mention place and State) and allotted Registration Certificate

No...................................... on the ..................day of .............................. 19.................

2. (i) I/We hereby declare that the situation of my/our premises where fertilizers are (a) stored

and (b) sold is as stated below:

(a)

(b)

Premises where

fertilizer are stored

fertilizers are sold

(ii)

I/We hereby declared that the fertilizer(s) in which I/we am/are carrying on the

business of selling and the name(s) of manufacturer(s)/Importer(s), Commodity Board(s),

State Government(s) and Wholesale Dealer(s) whom I/We represent are as stated below:

(a)

(b)

Name(s) of fertilizer (s)

Name(s) of manufacturer(s)/

Importer(s) Commodity Board(s).

Form C Clause 11 Application For Renewal Of The Certificate Of Registration