Madhya Pradesh Shops & Establishments Act, 1958
Application for Establishment Registration
Docket No. 1696024 Date of Application : 03/08/2021
Name of Applicant : RAJANI JAISWAL
Father's / Husband's Name : ASHOK KUMAR JAISWAL
Applicant's Status : Proprietor/Owner
Mobile No. : 8602975881
Address of Applicant : WARD NO 30/282 NEAR PARSHAD HOUSE PANDEN TOLA REWA
Name of Shop / Establishment : Herbal Beauty Parlour And Cosmetics Center
Address: Near Goverment School Gurh Chauraha Rewa District : REWA
Shop Type (Employee Wise) : 1 to 3 Employees Day of Weekly Off : Sunday
Old Registration No. (if Any): Owner Type : Proprietorship
Business Type : Any other Sales Shop
Category of Shop/Establishment : Shop Business Start Date : 05/07/2021
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DECLARATION
I, RAJANI JAISWAL S/o / D/o / W/o. Mr. ASHOK KUMAR JAISWAL do hereby solemnly affirm and declare that all information furnished
by me online and original documents scanned & uploaded by me along with this application are true to the best of my knowledge and belief and
I shall be responsible for any kind of false or fraudulent information and my Registration will be liable to be cancelled or withheld in any such
case without prior notice besides any other criminal/civil proceedings against me.
Signature of Applicant