FORM - B
Application for the issue of Special Licence to Deal in Rubber
 1.  LICENCE DETAILS
  Application No   Application Date Click Here to Pick up the date
  Name of the Applicant   Company Name
  Licence Year   Note : Licence will be issued in this name
Note : Year for which Application is to be considered
 2.  OFFICE DETAILS
Click Here To Add New Office Address Details Address in Full of the Place of Business
Note : Enter the Head Office Address as First Entry
Note :
  • Click the Plus button to add more Rows
  • Unselect the Checkbox to Remove the Unwanted Rows
 3.  STORAGE DETAILS
Click Here To Add New Storage Details Address in Full of the Place of Storage
Note :
  • Click the Plus button to add more Rows
  • Unselect the Checkbox to Remove the Unwanted Rows
 4.  OWNERSHIP OF THE FIRM
  Constitution Details
  Ownership Type  
Click Here To Add New Owner Details Details in Respect of the Owner / Each Partner for Partnership
 
Note :
  • Click the Plus button to add more Rows
  • Unselect the Checkbox to Remove the Unwanted Rows
OTHER DETAILS
 5.  Licence Details
  Have you been a Licenced Rubber Dealer under the Rubber Board Yes No  
 6.  From what Date have you been Dealing in Rubber
  Dealing Date Click Here to Pick up the date  
 7.  Invested Capital or Financial Standing of the Firm
  Invested Capital  
 8.  What was the Total Quantity of Rubber Purchased and Sold by you during the Previous Five Years ?
   
(If accurate figures are not available approximate figures may be given)
Period For which Licence Required
  Period From Date Click Here to Pick up the date   Period Till Date Click Here to Pick up the date
License Amount Fetch Page
Payment Details
Advance Amount Available
Data Not Available
  Type Amount To Pay Amount Paid Bal Amount to Pay  
Total
  Excess Amount Available :  0.00  
  Advance Deposit Available :  0.00  
List of Documents to be enclosed
 (i)  Affidavits
 (ii)  Proof of Payment of Fee
 (iii)  Partnership Deed / Certificate issued by Registrar of Firms / Memorandum & Articles of Association and Certificate of lncorporation issued by the Registrar of Companies / Copy of the Byelaws
 (iv)  Identity Card duly attested
   
   Place :
   Date : Click Here to Pick up the date
CREATION DETAILS
  Creation Date   Remarks
User Creation Details
Login Details
User Type Dealer
Application-No (User-ID)
Corporate Name
Contact Person/Name
Address
City
Pincode
State
District
Land Phone
Mobile
Email
Password
Repeat Password
Secret Question  
Secret Answer  
Date Click Here to Pick up the date
Place