Meeseva Civil Supplies FP SHOP RENEWAL Application Form

Meeseva Civil Supplies FP SHOP RENEWAL Application Form

Download Meeseva Civil Supplies FP SHOP RENEWAL Application Form

ANDHRA PRADESH STATE PUBLIC DISTRIBUTION CONTROL ORDER, 2001

APPLICATION FOR ISSUE OF AUTHORISATION TO RUN A FAIR PRICE SHOP
FP Shop Details:
Shop District: __________________________________
FP Shop Dealer ID: ___________________________
FP shop Address: __________________________________
____________________________________
FP Shop Dealer Details:
Dealer Name (In Capital Letters): ________
Father/Mother Name: __________________
Caste: ____________________
_____________________
Address: Door No: _____________
Locality/Landmark:
Mandal: ______________________ District: ___________
_______________ Pin cod
Mobile Number: _____________

Whether he is physically handicapped (YES/No
Whether the applicant is connected with any other b
usiness run either by himself or by any
details_______________________
_____________________________________
Whether any number of the applicant’s
family has been issued authorization to fair price
shop earl__________________
______________________________________________
Whether any of his blood relations is working in re
venue/CS Dept_____________________________________
Village location, Door number, when the applicant wants to run fair price
___________________________________________________
__________________________________
Whether he can raise the sufficient funds to run fair price shop with his own funds and if so give source or whether institutional finance
__________________________________________________
Whether he was convinced earlier for offence under
central order issued by the State/Central under E.C

Act.
___________________________________________________
______________________________
Amount, Challan number and date through which f_____________________________________________________
___________________________________________

I have carefully read the conditions of authorization under the Andhra Distribution Control Order, 2001 and I agree to abide
by them.
(a)I have not previously applied for such authorizatin in this district.
(b)I applied such authorization in this district on and was not granted.
(c)I hereby apply for renewal of authorization .....................................................................
............................................................................which is enclosed.
(Strike of the Clauses not applicable)

Procedure (following to be enclosed
1)Application Form*
2)Copy of Authorization letter*
3)Latest renewed food grains and kerosene License*
4)PHC Certificate (Certificate is enclosed in case he
is physically handicapped).