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Food Safety and Standards Authority of India Ministry of Health ...

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FORM – D<br />

CERTIFICATE FOR RENEWAL OF LICENCE UNDER LICENSING REGULATIONS<br />

Licence No. _______________<br />

Date <strong>of</strong> Issue _________<br />

Certified that Licence NO __________________________________________________ in the form C<br />

granted on the _________________________ to __________________________ for the<br />

sala/manufacture for sale/store/distribution/exhibition for sale <strong>of</strong> food items<br />

___________________________ by wholesale/.retail at the premises situated at<br />

______________________________ subject to the provision <strong>of</strong> the Licensing Regulations under the<br />

<strong>Food</strong> <strong>Safety</strong> <strong>and</strong> St<strong>and</strong>ards Act, 2006 renewed for a period from ______________________ to<br />

__________________ categories <strong>of</strong> trade. ________________<br />

Licensee shall abide by the conditions <strong>and</strong> requirements <strong>of</strong> the original license.<br />

Date:<br />

(Licensing authority)<br />

SEAL<br />

_____________________<br />

20

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