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Application

The document is an application for registration under the Food Safety and Standards Act, 2006 for a food service business named AGRO LINE, which operates as a retailer of snacks and tea in Thiruvananthapuram, Kerala. The applicant has provided necessary details including address, contact information, and food category, and has declared compliance with food safety regulations. The intended start date for the business is July 19, 2025, with an expected annual turnover under Rs. 12 Lacs.

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rineesarinees168
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26 views2 pages

Application

The document is an application for registration under the Food Safety and Standards Act, 2006 for a food service business named AGRO LINE, which operates as a retailer of snacks and tea in Thiruvananthapuram, Kerala. The applicant has provided necessary details including address, contact information, and food category, and has declared compliance with food safety regulations. The intended start date for the business is July 19, 2025, with an expected annual turnover under Rs. 12 Lacs.

Uploaded by

rineesarinees168
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Food Safety Compliance System (FoSCoS)

https://foscos.fssai.gov.in
Form A
[See Regulation 2.1.1, Regulation 2.1.7]

Application for Registration under food safety and Standards Act,2006

Application No: 30250719120803275 Application Type: New Registration


Name of Applicant / AGRO LINE Application Date: N/A
Company: Kind of Business: Food Services - Petty
Designation: Individual Retailer of snacks/tea
shops

Address of Premises Where Food Business Is Located

Address: KP13/559-1 Near State: Kerala


St Andrews
Sub-Division/Station/ Thiruvananthapuram
Ground
Division: Circle
Thiruvananthapur
am Pan No: N/A

District/Region/Zone: Thiruvananthapur
am
Village: N/A
Pin Code: 695558
Nearest Landmark: St Andrews
Ground

Correspondence Address Details

Address: KP13/559-1 Near State: Kerala


St Andrews Sub-Division/Station/ Thiruvananthapuram
Ground Division: Circle
Thiruvananthapur
Pin Code: 695558
am
District/Region/Zone: Thiruvananthapur
am
Village: N/A

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 9037331247 Email-ID: N/A
Contact Person: Rinees A Aadhaar No: 70XXXXXXXX09

Other Details

In case of New business – intended date of start: 19-07-2025

Page 1 of 2
Source of Water Supply: Public
Sanction Electricity Load or HP Used: No
Number of years applied for: 1

Detail(s) of Food Item

[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]

Other than Manufacturer Unit


Sl. No Name of the food category
1 07 - Bakery products

Document(s) Details

S.No. Documents Description Uploaded Document


1 Photo View
2 Identity Proof - Aadhar Card View

Other Document(s) Details

S.No. Documents Description Uploaded Document


1 Photographs of the unit (Entrance/Front facing end of the unit) view

I/We declare that:


I/We have read,understood and shall abide all provisions of FSS Act,2006 and Rules, Regulations made
therein and orders issued from time to time applicable to declared food business.
I/We assure that articles of food mentioned in form satisfy the requirements of FSS Act 2006, Rules and
Regulations made thereunder.
I/We shall comply with the general hygiene and sanitary requirements as mentioned in the Schedule 4 of
the FSS (Licensing and Registration of Food Businesses) Regulations, 2011.
Expected Annual turnover of the food business is under Rs.12 Lacs. I will apply for License as and when
annual turnover of food businesses exceeds Rs. 12 Lacs.
I have read/understood the punishment provision under Section 61 of FOOD SAFETY AND STANDARDS ACT,
2006."61. Penalty for false information. If a person, in connection with a requirement or direction under this
Act, provides any information or produces any document that the person knows is false or misleading, he
shall be liable to penalty which may extend to ten lakh rupees."

I do hereby solemnly affirm and declare that all information and particulars furnished here by me are true and
correct to the best of my knowledge.

Declaration || Condition of License || Inspection Checklist

घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची

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