आवेदन-पत्र
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13.3 (A) उर्वरक मिश्रण विनिर्माण लायसेंस जारी करना
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13.3 (A) Issuing Certificate of Manufacture of Physical/Granulated/Special Mixture of Fertilizer | | |
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| 1.Udyog Aadhar number * |
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| 2.(a).Name of the applicant * |
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| (b).Applicant Address with Pin code * |
Max Length 250 characters |
| (c).Mobile No. * |
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| (d).Email Id * |
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| 3.Does the applicant posses the qualification prescribed by the state Government under sub clause (i) of clause 14 of the fertilizer (control) order, 1985? * |
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| 4.Is the applicant a new comer? * |
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| 5.Situation of the applicant’s premises where physical/granulated mixture will be prepared. * |
Max Length 250 characters |
| 6.Full particulars regarding specification of the physical granulated/special mixture of fertilizers for which the certificate is required and the raw material used in making the mixture. * |
Max Length 200 characters |
| 7.Full particulars of any other certificate of manufacturer, if any issued by any other Registering Authority. |
Max Length 200 characters |
| 8.How long has the applicant been carrying on the business of preparing physical/granulated/special mixture of fertilizers mixture of micronutrient fertilisers ? |
Max Length 250 characters |
| 9.Quantity of each physical/Granulated special mixture of fertilizers/ mixture/of micro nutrient fertilisers(in Tones) in my/our possession on of date of the application and held at different addresses noted against |
Max Length 200 characters |
| 10.(I) If the applicant has been carrying on business of preparing physical/granulated/special mixtures/ of fertilizers//mixture of micronutrient fertilizers/give all particulars of such mixtures handled |
Max Length 250 characters |
| (a).Period of which mixing of fertilizers was done |
Max Length 200 characters |
| (b).Place(s) of which the mixing of fertilizers was done |
Max Length 200 characters |
| (II) Also give the quantities of physical/granulated/special mixture/ of fertilizer handled during past calendar year |
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| 11.In case of special mixture of fertilisers Name and Address of the person requiring the special mixture of fertilisers * |
Max Length 200 characters |
12. Fertiliser Details |
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| 13.M/s/Firm Name * |
Max Length 200 characters |
14. मैं अपने प्रमाण-पत्र को अपने डिजिटल लॉकर में रखने की सहमति प्रदान करता हूँ। (असहमति के लिये अनटिक करें)
(यह सहमति/असहमति आवेदक से पूछ कर आवश्यक रूप से अपडेट की जाय) |
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DECLARATION (a)I have Deposited the prescribed registration certificate fee/renewal fee
(b)I/We declare that the information given above is true and correct to the best of my/our knowledge and belief, and no part there is false.
(c)I/We have carefully read the terms and conditions of certificate of manufacture given in form F appended to the fertilizer (control) order, 1985 and agree to abide by them.
(d)I/We declare that the physical/granulated mixture/organic fertilizer/bio fertilizer for which certificate of manufacture is applied for shall be prepared by me/us State Government from time to time or by any other person under my/our direction, supervision and, control or under the direction supervision and control of person having the said qualifications.
(e)I/We declare that the requisite laboratory facility specified by the controller, under this order is possessed by me/us.
(f)In case of special mixture of fertilisers ;
I am enclosing an attested copy of the requisition made by the purchaser of the special mixture of fertilisers | | |
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| आवश्यक दस्तावेज (आवेदक द्वारा स्वप्रमाणित) : |
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