Form "A"

lsee Rsgulplion 2*1.I. and fiegulatioc-eJ;

Apptication for Registration under Food Safety and Standards Act, 2006

Application No: 301911 15230058083

Name of Applicant / ComPanY ARJUN SINGH HALWAIAND CATERERS

Kind of Business : Food vending establishment

Designation 1 ProPrieter

Address of Premises where food business is located Correspondence Address Details

J-1,GALl NO-2,H.NO-566/B,SANGAM J-1,GALr NO-2,H.NO-566/8,SANGAM

Address Address
VIHAR VIHAR

Delhi State Delhi

State
South District/Regionlzone South
District/Regionlzone
Sub- Sub-
MEHRAULI Division/station/Division MEHRAULI
Division/Station/Division
(Railways) (Railways)

MEHRAULI Village MEHRAULI

Village
770062 Pin Code 110062
Pin Code

Contact Details

Tel No NA Mobile No 88s1349134

Fax No NA Email 56TTritikasharma @gmail.com

Contact Person Arjun singh

Other Details
ln case of New business - intended date of start : NA

ln case of sessional business, state the opening and closing period NA _NA
of the year :
Source of Water SuPPIY : Private

Sanction Electricity Load or HP Used : NA

Upload Photo: 2019/1 1/RG PH I D30 19 11 15230058083'j psg

Upload Document for ldentity Proof Aadhaar Card

(eg: Ration Card, Voter !D Card etc.) 2019/1 1/RG I p3019 1 115230058083. pdf

Description of the food items proposed to be manufactured or sold:

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1 - Dairy products and analogues, excluding products of food category 02.0

15 - Ready-to-eat savouries
- Beverages, excluding dairy products
- Prepared Foods
5 11- Sweeteners, including honeY

Submitted Document(s)
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1 rDeclarati on Form

Place: D c-[-tt .is

Oate: lC 1r ?o 11 (Signature of the Applicant)