Application for grant of Wholesale and Retail Licenses To The Licensing Authority/ DFSC Dist.______________________ __________________________ Sir, I hereby apply for the grant of license under the Punjab Trade Articles (Licensing and Control) Order, 1992.The required particulars are given here under:- 1. (I) Applicant's Name ____________________ (2) Son Of Sh._________________________ 2. Whether Scheduled cast or Backward Class, if so indicate caste ________________ 3. Complete Address of the applicant ________________________________________ ___________________________________________________________________ 4. Name and style in which license is required, If Different from clause No.1. 5. Location with complete particulars of applicant's place of business. 6. If the firm has Partnership, give names of the partners: - Sr. No. Name of the Partners Complete Address _____ __________________ _____________________________ _____ __________________ _____________________________ 7. Particulars of trade articles in which the applicant wants to carry an business: - As a wholesaler As a Retailer 1. _____________ _______________ 2. _____________ _______________ 3. _____________ _______________ 8. Did the applicant previously hold a license of the trad articles for which license has now been applied for. If so, give details: - (i) Name of the trade article___________________ (ii) License No. _____________________________ (iii) Issued by _______________________________ (iv) Amount of security deposited with particulars of Passbook/ National Saving Certificates____________________ 9. Does the applicant want to get the security mentioned at item number 8 to be adjusted towards the security of the license now applied for: Yes/No 10. Complete Address(with House No., Mohalla etc.) of Godowns Place where the trade articles for which license has been applied for will be stored :- 1. _____________________ 2. _____________________ 3. _____________________ 4. _____________________ 11. Has the applicant ever been convicted by the court of law for contravention of any order issued under the essential Commodities Act, 1955, or any other Act or order mentioned in Clause 13 during the last 3 years ? 12. (a) Has the license held by the applicant been suspended or cancelled during the last 3 years ? (b) If the answer is yes, give the following particulars: - (i) Name and No. of license ______________________ (ii) Date of suspension or cancellation along with the name of the Authority suspending or cancelling the license. 13. Whether the applicant was declared or adjudged as an insolvent by any court. I declare that particulars mentioned at item No. 1 to 13 above are correct to the best of my knowledge and belief and nothing has been concealed therein. I have carefully read with provisions of the Punjab Trade Articles( Licensing and Control) Order, 1992, and I agree to abide by them and to the direction issued by the competent authority from time to time. Place:______________ Signature of Prop. or Partner Dated:______________
