FSSAI Registration

Application / Service Intake Summary

Business Particulars

Business / Entity Name	{{business_name}}
Constitution of Business	{{constitution}}
Kind of Business	{{kind_of_business}}
License Type Applied	{{license_type}}
Category of Food Products	{{food_category}}
Premises / Business Address	{{business_address}}
Number of Employees	{{number_of_employees}}
Estimated Annual Turnover (Rs.)	{{annual_turnover}}
PAN	{{pan}}

Applicant Particulars

Applicant Name	{{applicant_name}}
City / State	{{city}}, {{state}}
Mobile	{{mobile}}
Email	{{email}}

Documents Submitted

Applicant Identity Proof
Passport-size Photograph
Business Address Proof
Premises Layout Plan / NOC

Declaration

I, {{name}}, the applicant / authorised signatory of the above food business, do hereby declare that the particulars furnished herein are true, complete and correct to the best of my knowledge and belief. I undertake to comply with the Food Safety and Standards Act, 2006 and the rules and regulations made thereunder, and authorise the processing of this application for FSSAI registration / license.

Place: {{place}}
Date: {{application_date}}

_____________________________
Signature of Applicant
({{applicant_name}})

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Required documents