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: 30250104118679283 Application Type: New Registration
Name of Applicant / SURA KAAB YAKUB Application Date: N/A
Company: C/O B-DRYFRUIT Kind of Business: Trade/Retail -
Designation: Individual Wholesaler, Trade/
Retail - Distributor,
Trade/Retail - Retailer
Address of Premises Where Food Business Is Located
Address: SHOP NO 8, ROYAL State: Maharashtra
CRYSTAL, TRIVENI
Sub-Division/Station/ Greater Mumbai Ward-
NAGAR, KURAR
Division: P/N
VILLAGE, MALAD
EAST Pan No: LOBPS8651B
Name: SURA KAAB YAKUB
District/Region/Zone: Greater Mumbai
DOB: 28-02-2001
Village: Malad (E)
Gender: MALE
Pin Code: 400097
Nearest Landmark: JYOTI HOTEL
Correspondence Address Details
Address: A 503, Al MAKHHA State: Maharashtra
APARTMENT, R .S Sub-Division/Station/ Greater Mumbai Ward-
MARG, Division: P/N
PATHANWADI,
Pin Code: 400097
MALAD EAST,
District/Region/Zone: Greater Mumbai
Village: Dindoshi
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 7738444541 Email-ID: nisarshaikh2009@gmai
Contact Person: SURA KAAB YAKUB l.com
Aadhaar No: 53XXXXXXXX95
Other Details
In case of New business – intended date of start: 04-01-2025
Source of Water Supply: Public
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Sanction Electricity Load or HP Used: No
Number of years applied for: 1
Detail(s) of Food Item
[Note:Only standardised food products are allowed to be manufactured as per the list available on FoSCoS.]
Other than Manufacturer Unit
Sl. No Name of the food category
1 01 - Dairy products and analogues, excluding products of food category 2.0
2 03 - Edible ices, including sherbet and sorbe
3 05 - Confectionery
4 07 - Bakery products
5 10 - Eggs and egg products
6 11 - Sweeteners, including honey
7 12 - Salts, spices, soups, sauces, salads and protein products
8 14 - Beverages, excluding dairy products
9 15 - Ready-to-eat savouries
10 18- Indian Sweets and Indian Snacks & Savouries 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
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. Penalty 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 liable to penalty which may extend to ten lakh rupees."
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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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