Application

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Food Safety Compliance System (FoSCoS)

https://foscos.fssai.gov.in
Form A
[See Regulation 2.1.1, Regulation 2.1.7]

Application for Registration under food safety and Standards Act,2006

Application No: 30230624113755676 Application Type: New Registration


Name of Applicant / THE PIZZA TIME Application Date: N/A
Company: HOUSE Kind of Business: Food Services -
Designation: Proprieter Restaurants

Address of Premises Where Food Business Is Located

Address: C/O SUDHA, State: Rajasthan


GIRRAJ COLONY,
Sub-Division/Station/ Dholpur
GT ROAD
Division(Railways):
District/Region/Zone: Dhaulpur Pin Code: 328001
Village: Dhaulpur Pan No: BSTPT0371D
Nearest Landmark: NEAR RAJAKHERA
BY PASS ROAD

Correspondence Address Details

Address: S/O CHARAN State: Rajasthan


SINGH TOMAR, Sub-Division/Station/ Dholpur
SUBEDAR KA Division(Railways):
PURA, BAREH
Pin Code: 328001
MORI
District/Region/Zone: Dhaulpur
Village: Bareh Mori

Contact Details

Telephone No: N/A Fax: N/A


Mobile No: 6375721788 Email-ID: Santoshsinghtomar51
Contact Person: SANTOSH TOMAR [email protected]

Other Details

In case of New business – intended date of start: 24-06-2023


Source of Water Supply: Private
Sanction Electricity Load or HP Used: No
Number of years applied for: 1

Detail(s) of Food Item

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[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]

Other then Manufacturer Unit


Sl. No Name of the food category
1 15 - Ready-to-eat savouries
2 16 - Prepared Foods
3 07 - Bakery products

Document(s) Details

S.No. Documents Description Uploaded Document


1 Photo View
2 Identity Proof - Aadhar Card View

Other Document(s) Details

S.No. Documents Description Uploaded Document


1 Proof of Premises view
2 declaration view

I/We declare that:


I/We have read,understood and shall abide all provisions of FSS Act,2006 and Rules, Regulations made
therein and orders issued from time to time applicable to declared food business.
I/We assure that articles of food mentioned in form satisfy the requirements of FSS Act 2006, Rules and
Regulations made thereunder.
I/We shall comply with the general hygiene and sanitary requirements as mentioned in the Schedule 4 of
the FSS (Licensing and Registration of Food Businesses) Regulations, 2011.
Expected Annual turnover of the food business is under Rs.12 Lacs. I will apply for License as and when
annual turnover of food businesses exceeds Rs. 12 Lacs.
I have read/understood the punishment provision under Section 61 of FOOD SAFETY AND STANDARDS ACT,
2006."61. Punishment for false information. If a person, in connection with a requirement or direction under
this Act, provides any information or produces any document that the person knows is false or misleading,
he shall be punishable with imprisonment for a term which may extend to three months and also with fine
which may extend to two lakh rupees"

I do hereby solemnly affirm and declare that all information and particulars furnished here by me are true and
correct to the best of my knowledge.

Declaration || Condition of License || Inspection Checklist

घोषणा || अनुज्ञिप्त की शतेर्ं || िनरीक्षण जांच सूची

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