GOVERNMENT OF JAMMU AND KASHMIR GENERAL ADMINISTRATION DEPARTMENT Application for the Grant/Renewal of License (Retail) for the sale of Coal under Clause 4(1) To The District Magistrate, 1. Name of applicant (in block letters) ________________________________ 2. Residential address of the applicant ________________________________ 3. If the application is made on the behalf of a firm, an incorporated company or a cooperated society, state the trading name and the names of the proprietors, partners, managing directors as the case may be ________________________________ 4. Exact address of go down or place of business or place of storage. State also the Municipal number, if any ____________________________________ 5. State for how long have you been in coal business ________________________ 6. Have you or any of your partners ever been prosecuted for a brench of any Control Order? Give particulars in brief _____________________________________ I hereby apply for renewal of license No._____________, dated ______________, issued to me on ________________________. I solemnly declare that the above particulars are correct to the best of my knowledge and belief. Signature of Applicant.
