Madhya Pradesh Shops & Establishments Act, 1958

Application for Establishment Registration

Docket No. 1221493 Date of Application : 28/12/2019
Name of Applicant : SANDESH JAIN
Father's / Husband's Name : SUNIL JAIN

Applicant's Status : Proprietor/Owner

Mobile No. : 7415515614
Address of Applicant : WARD NO. 1, JAIN MANDIR K PICHHE, ALIPUR , ASHTA
Name of Shop / Establishment : SONICA KANGAN STORE
Address: PURANA ALIPUR District : SEHORE
Shop Type (Employee Wise) : 1 to 3 Employees Day of Weekly Off : Not Applicable
Old Registration No. (if Any): Owner Type : Proprietorship
Business Type : General Store (Other than Kirana)/FMCG/Dairy Shops/Other Consumables
Category of Shop/Establishment : Shop Business Start Date : 12/12/2019

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DECLARATION
I, SANDESH JAIN S/o / D/o / W/o. Mr. SUNIL JAIN do hereby solemnly affirm and declare that all information furnished by me online and
original documents scanned & uploaded by me along with this application are true to the best of my knowledge and belief and I shall be
responsible for any kind of false or fraudulent information and my Registration will be liable to be cancelled or withheld in any such case
without prior notice besides any other criminal/civil proceedings against me.

Signature of Applicant