Form "A"
[See Regulation 2.1.1 and Regulation 2.1.7
Application for Registration under Food Safety and Standards Act, 2006
Application No: 30190413172249153
Name of Applicant / Company : M/S. Hotel Bombay Khanaval
Kind of Business : Hotel
Designation : Proprieter
Correspondence Address Details
Address of Premises where food business is located
Sangar galli,Near Ganpati
Address : E-861,Opp.S.T.Stand,Mhaswad Address :
mandir,Mhaswad
State : Maharashtra
State : Maharashtra
District/Region/Zone : Satara
District/Region/Zone : Satara
Sub-
Sub-
Division/Station/Division : Man
Division/Station/Division : Man
(Railways)
(Railways)
Village : N/A
Village : N/A
Pin Code : 415509
Pin Code : 415509
Contact Details
Tel No : NA Mobile No : 9403345766
Fax No : NA Email : shekhardamakale@gmail.com
Contact Person : 9403345766
Other Details
In case of New business – intended date of start : NA
In case of Sessional business, State the opening and closing
NA -NA
period of the year :
Source of Water Supply : Public
Sanction Electricity Load or HP Used : NA
Upload Photo : 2019/4/RGPHID30190413172249153.jpg
Upload Document for Identity Proof PAN Card
(eg: Ration Card, Voter ID Card etc.) 2019/4/RGID30190413172249153.jpg
Description of the food items proposed to be manufactured or sold:
Sl. No. Name of the food category
1 07 - Bakery products
Submitted Document(s):
Sl. No. Document Description Uploaded Document
1 Health NOC 2019/4/30190413172249153_1507_16042019042009.jpg
2 NOC by Municipality/Panchayat 2019/4/30190413172249153_1503_16042019041753.jpg
3 Any Other Document 2019/4/30190413172249153_1519_16042019042247.jpg
4 Declaration Form 2019/4/30190413172249153_301_13042019054248.jpg
Place :
____________________
Date : (Signature of the Applicant)