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आवेदन-पत्र
13.1(C) बीज विक्रय लायसेन्स जारी करना
FORM "A"
(See clause 4 of Seeds (Control) Order, 1983)
FORM OF APPLICATION TO OBTAIN DEALER’S LICENCE

1. Full name and address of the applicant:

(a) Name and postal address:


(i) Name of the Applicant:
*
(ii) Firm/Company/Society/HUF/Individual Name
*
(iii) Postal Address of Applicant
*

Max Length 180 characters

(iv) Email ID
*
(v) Official Telephone No.
*
(vi) GST No.
(vii) PAN No.
(b) Place of business (Please give exact address)
(i) For Sale
*

Max Length 180 characters

(ii) For Storage
अध्यतन करने हेतु विकल्प हटाने हेतु विकल्प सं. क्र. Place of Storage
Place of Storage *
2. Type of Business Entity *
3. In what capacity this application is made *
Give the name(s) and address(es) of the Proprietor/Partner/Manager/Karta
अध्यतन करने हेतु विकल्प हटाने हेतु विकल्प सं. क्र. Name Address
Name *
Address *
4. Was the applicant ever convicted under the Essential Commodities Act, 1955(10 of 1955) or any order issued there under during the last three years preceding the date of application? *
If 'YES' then, give details.

Max Length 180 characters

5. Give the Name of the Seed Producer/Company/Committee and seed details to be handled
अध्यतन करने हेतु विकल्प हटाने हेतु विकल्प सं. क्र. Name of the seed(s) Source/Authorization Letter provider name Valid Upto (DD/MM/YYYY)
Name of the seed(s) *
Source/Authorization Letter provider name *
Valid Upto (DD/MM/YYYY) *
6. Method Of Payment *
6.1 Challan/Transaction Details
(i) Licence Fee (In Rs.)
(ii) Challan No
(iii) Challan Date (DD/MM/YYYY)
(iv) Bank Name
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)
Declaration
(a) I/We declare that the information given above is true to the best of my/our knowledge and belief and no part thereof is false.
(b) I/We have carefully read the terms and conditions of the licence given in the form "B" appended to the Seeds (Control) Order, 1983, and agree to abide by them.
Note : 1. Where the business of selling/exporting/importing seeds is intended to be carried on at more then one place, a separate licence should be obtained for each place
आवश्यक दस्तावेज (आवेदक द्वारा स्वप्रमाणित) :










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Source: https://mpedistrict.gov.in Sunday, June 23, 2024 3:44 AM