FOR THE PERION………………...

LICENCE NO………………………

1. Name of the Applicant :

2. Father’s name :

3. Address or Addresses :

a) Residential :

b) of the business

Establishment :

4. Nature of the business

undertaking :

5. Average quantity sold by the

applicant during the last 3

(three) months seck :

6. Quantity of retail sales

for which license is being

sought for :

Agartala, Date :

The ………………2000                                            Signature of the Applicant

N.B. Only person having joint family or partnership business need apply together Separate application is required for separate place of business.