SCHEDULE-II

Form ‘A’

SEE CLAUSE 4 (1)

THE TRIPURA SUGAR-DEALERS LICENSING ORDER 1971

Application For Grant / Renewal of License.

 

  1. Applicant Name :-
  2. Father’s name :-
  3. Applicant’s Profession :-
  4. Applicant’s Residence :-
  5. Situation of applicants place or

    Places of business with particulars as

    to the number or house, Mahalla

    village, Town Police Station :-

  6. How long the applicant been trading in

    Sugar :-

  7. Did the applicant hold a Sugar

    license on any previous occasion (if

    so give particulars including

    suspension or cancellation if any) :-

  8. Quantity of Sugar likely to be handled
    Annually during the last years :-
  9. Quantity of Sugar likely to be handled
    Annually during the current year :-
  10. Income tax paid in the year

    Proceeding the applicant’s

    ( To be indicate separately ) :-

  11. a) Quantity of Sugar in the

    possession of applicant
    on the date of application and

    place at which the different quantities

    are kept :-

I declare that the quantities of Sugar specified above are to my possession this day and hold at the place noted against them.

I have carefully read the conditions of License given in form ‘B’ appended to the Tripura Sugar Dealer’s Licensing Order, 1991.
  1. I have not previously applied for such license for which licensee in this district Territory.
  2. I applied for such license in the District/Territory for ……………………………...

    of ……………………. Was/not granted a license ………………….

  3. I hereby apply for renewal of license No.

 

………… Dated ………………. issued to me on ……………..

Date …………………….

Place ……………………

 

                                                  Signature of the Applicant
    • Strike out the Clause not applicable.