AGARTALA MUNICIPAL COUNCIL AGARTALA Application form for Municipal License (Under Section 188, 201 etc of the Tripura Municipal Act, 1994) For the Period of .......................... Part - A 1. Name of the Applicant with Father's /Husband's name & address :- 2. Name and address of the Trade/ Profession (including the name of Firm if any):- a) Ward No. :- b) Market / Commercial Center:- c) Lane/By Lane:- d) Holding no :- i) Owner of the Holding: - ii) Relationship with (i) e) Nature of Trade f) Style of Business: - (i) Agent/Stockist (ii) Wholesale (iii) Retail 3) Name Father's/Husband's name of the Proprietor/Partner of the Shop/Firm /Factory/Institute:- 4) Status of Business:- Permanent /Mobile .................. 5) Total Area under Commercial use :- ......... sq. Ft 6) If there is any other License linked with this Trade:- a) Name of License :- i)...... ii) ....... iii)........ b) Name of Licensing Authority :- i) ....... ii)...... iii) ..... Part- B Land/ Building Particulars: - 1) Land /Building belongs to self or rented or AMC Touji :- 2) If Touji, mention Touji No:- 3) How many AMC water connection in the Holding /Touji:- 4) I/We hereby declare that the particulars furnished above is true. 5) I/We undertake to comply with the terms & conditions applicable to the license. Signature of the applicant with date Remarks of the Inspecting Officer Order of the Licensing Authority
