ITANAGAR MUNICIPAL CORPORATION
APPLICATION FORM FOR ISSUE NEW/RENEWAL OF TRADE LICENCE
To, Affix two
The Commissioner
stamp size
Itanagar Municipal Corporation
Itanagar Photograph
Sir,
The Particulars of my business are as given below:-
1. Name of the applicant :________________________S/o, W/o,D/o______________________________
2. Present/Permanent address :Ward No.______________ Sector/Colony: __________________House
No.:_________________ P.O/P.S_____________________ Dist._________________________________
3. Place of Business/Shop :_________________________________________________________________
4. Business Structure is of :1) Permanent 2) Semi permanent 3)Temporary
5. Place of Business is at :1)Commercial area 2)Domestic area 3)Sector area
6. Enclosed Land/plot Allotment No:___________________________________Commercial/Residential: (please
tick (√) the appropriate option )
7. Enclosed Address Proof Document (i.e. Voter ID/AAdhar Card/ST Certificate/Electric Bills etc.):
8. Name of Shop :_________________________________________________________________
9. If the applicant is a firm, give details of all partners constituting the firm with full
address:____________________________________________________________________________________
10. Has the applicant or his/her associate member been granted any licence under the act and rules and whether
such licence has been suspended or cancelled, if so, when and for what period and for what reason, give details
:___________________________________________________________________________________________
11. Particulars of the business for which the licence is required :-
(For selling of/dealing with etc.)
I. ___________________________________________
II. ___________________________________________
III. ___________________________________________
IV. ___________________________________________
V. ___________________________________________
VI. ___________________________________________
I do hereby certified that the information given above are true to best of my knowledge. I undertake to abide by the
provisions under section 111, subsection 1(b) and 2(b)of Arunachal Municipal Act’ 2019(Act no. 8 of 2019) and
Arunachal Pradesh Building Bye-Law 2010 of Govt. of Arunachal Pradesh.
Verified by: Signature of Applicant
Signature of Ward Corporator Name:
(With Seal) Mobile No.:
Email Id (if any):