ULHASNAGAR MUNICIPAL CORPORATION CITIZEN FACILITATION CENTRE SUBJECT: ADD OR REMOVE THE PARTNERS IN THE ISSUED LICENSE Token Number (For Office Use) Date:- / / (If Citizen Identification Number is given, do not fill below Details) Applicant's Details: Last Name/ Surname Name Father/Husband's Name Details of Society (If Application from Society): Name Of Society: Designation Address: Head Information House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Ward Committee No.: 1 [ ] 2 [ ] 3 [ ] 4 [ ] Electrol Panel No.: Telephone No. (if any): Contact Person: Email Address (if any): Information of Property: Head Information Type of Property (Please Tick [?] as applicable) [ ] Land [ ] Building Property Number (Computerized) Necessary Particulars about above service: Head Particulars 1 License Number 2 Name of the License Holder 3 Name of the Business Citizen Identification Number 4 Address of the Business Pin 5 Details of Business 6 Names, age and address of the persons to be added / removed from the license Name of Partners Last Name/ Surname Name Father/Husband's Name Age Sex Addresses of Partners 1 Pin 2 Pin 3 Pin 4 Pin (Note: In case the numbers of nominees are more than 4, then mentioned it on seperate page.) Details about the addition or removal of partners and its valid reasons Necessary Enclosures related to above application are enclosed as under. (If enclosed tick [ ? ] or not enclosed tick [?] ) Enclosures Yes/No 1 NOC from the original license holder(s) for including / adding the name(s) of partner(s). This should be in the name of Corporation. [ ] 2 Copy of Registration Deed, for the partnership firm [ ] 3 NOC from the license holder who's name is to be exclued / removed. This should be in the name of Corporation. [ ] 4 Original copy of the license [ ] Declaration I/We ................................................................................................... state on solemn affirmation that the above information is true and correct to the best of my/our knowledge. If the information given is found wrong then I/We shall be held legally liable for its consequences. Date:- Applicant's Signature ( ) The document may please be deliverd to: 1. Self/Nominated Person [ ] a) C.F.C. [ ] b) Camp No. [ ] Name of Nominated Person (________________________________________________) 2. By Post a) U.P.C. [ ] b) Register A.D. [ ] 3. Courier [ ] (Not to be filled if address is same as above) Correspondence Address:- Last Name/ Surname Name Father/Husband Name House/Building/Soc. Name: Flat/Block/Barrack No.: Wing/Floor: Road/Street/Lane: Area/Locality/Town/City: Taluka: Pin code: Email Address (if any):
