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State of Chattisgarh - Section
Section 20 in Chhattisgarh Krishi Upaj Mandi (Special Licence for more than One Market Areas) Rules, 2007
20. Submission of returns by the holder of special licence.
| 1. | Name of the Applicant/Firm, Address who/ whichdesires to do business in market areas. | |
| 2. | Name of the Applicant, Father's Name and FullAddress : | |
| Telephone No. | ||
| 3. | The Applicant is other than the Individual, thenname and address of the firm/Hindu undivided family/company/namesof all the workers/ partners/ directors and full address. |
| Name | Father's Name | Age | Address | Telephone No. | Name of the Police Station |
| (1) | (2) | (3) | (4) | (5) | (6) |
| 4. | If the applicant firm is a company or is acooperative society, then the registration No. and date. | |
| 5. | Previous year's Licence No. (If any) | |
| 6. | Applicant's Commercial Tax No. and TIN No.Central Commercial Tax Registration No. | |
| 7. | Applicant's Permanent Account No. of Income Tax(PAN) | Photo copy enclosed - yes/no |
| (Please enclose Photo copy) | ||
| 8. | Name and Account No. of Bank in which theapplicant has account. |
| S. No. | Name of the Bank | Type of Account | Account No. | On the date of Application deposit amount in theaccount | Remarks |
| (1) | (2) | (3) | (4) | (5) | (6) |
| (Please enclose verified photo copy of all BankAccount to certify the available fund in bank account by theBranch Manager) | ||
| 9. | Capital invested by the applicant, firm etc. | |
| (Please give details) | ||
| 10. | Name of the market areas shown by the applicantin which business is proposed. |
| S. No. | Name of the Market Area shown | Name of the concerned market committee | Estimated Quantity of proposed agriculturalproduce for purchase in the market area shown [see Rule 3 (2)] |
| (1) | (2) | (3) | (4) |
| 11. | Name of the purchase centres proposed by theApplicant in the shown market area | |
| (Please enclose the lay out) |
| S. No. | Name of the Market Area shown | No. and the name of the proposed purchasecentres in every market area shown | Name of the purchase centre In-charge Manageradd. Telephone No. | Estimated quantity of agricultural produce forpurchase at the proposed purchase centre | Estimated market value of proposed produce |
| (1) | (2) | (3) | (4) | (5) | (6) |
| 12. | Information of facilities ensured at thepurchase centre from the applicant | |
| (a) Electronic Weighbridge. | ||
| (b)Arrangement of Fresh Drinking Water. | ||
| (c) Arrangement of sufficient Light & Shed. | ||
| (d) Payment Counter/Officer. | ||
| (e) Other facilities which are available | (One) | |
| (Two) | ||
| (Three) | ||
| 13. | Layout of the purchase centre shown in Form No.11, of Godown available and storage capacity (Please enclose listand give information of the name, etc. of the owner of thegodown) |
| S. No. | Name of the Purchase centre | Available godown | Place of the godown | Name of the owner of godown | Place/position | Particulars of the land. etc. if the centregodown land is available |
| (1) | (2) | (3) | (4) | (5) | (6) | (7) |
| 14. | How much quantity or notified agriculturalproduce purchased last year at the approved purchase centres asper Point No. 10 & 11 (Enclose the list) |
| S. No. | Name of the Market | Name of the Purchase centre | Quantity of the agricultural produce purchased | Value of the produce |
| (1) | (2) | (3) | (4) | (5) |
| 15. | List of the persons/servants authorised to workfor the business of notified agricultural produce at all thepurchase centres from the applicant firm. | |
| S. No. | Name | Father's name | Address | Telephone No. |
| (1) | (2) | (3) | (4) | (5) |
| Allotted work and fixing of responsibility (Incase of any change in the allotted work, the information will begiver to the administrative market committee) | Designation capacity in the Firm/company/societyas owner/partnership/Director/Manager etc. | Specimen signatures (two) |
| (6) | (7) | (8) |
| 16. | List of the main place of business, head office,main office and branches, of the company/ firm/society. |
| S. No. | Main Place of business | Head Quarter office | Name/Address of branches | Name of branch in-charge, address telephone No.Office/Residence | Name of Head of the office, address TelephoneNo. Office/Residence |
| (1) | (2) | (3) | (4) | (5) | (6) |
| 17. | Does the Applicant wish to purchase in thespecified market/sub-market yards of more than one market areas.If yes, then |
| S. No. | Name of the market committee and themarket/sub-market yard | Particulars of godown/shop available inmarket/sub-market yard |
| (1) | (2) | (3) |
| 18. | Is or has been in past, the applicant a licenceholder of any market committee of the State ? if Yes, then givedetails : - |
| S. No. | Name of the firm and the market | Licence Year | Type of the Licence | Quantity and value of the notified agriculturalproduce purchased last year in................ | Market fee paid |
| (1) | (2) | (3) | (4) | (5) | (6) |
| 19. | (I) Has the Licence been suspended or cancelledduring the past five years by any market committee ? | ||||
| (II) has any Penalty been imposed by marketcommittee ? If Yes, then give reason : - | |||||
| 20. | Name of notified agricultural produce for thebusiness of which Licence is required. | ||||
| 21. | Total (estimated) quantity of the notifiedagricultural produce to be purchased at every purchase centre,shown/specified by the applicant. |
| S. No. | Name of the market area | Proposed purchase quantity of the notifiedagricultural produce |
| (1) | (2) | (3) |
| 22. | I/We declare that I/We have read and understoodthe Chhattisgarh Krishi Upaj Mandi Adhiniyam 1972, rules andbye-laws framed thereunder. I/We will adequately comply withthem and they will be acceptable to me/us. |
| Place.............. | Signature of the Applicant and Seal |
| Date................... | (including designating capacity) |