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Bio-Diesel Outlet Application Form

This document is an application for a proposed bio-diesel outlet. It requests personal information from the applicant such as name, address, contact details, as well as details about the proposed outlet such as its name, address, type of business and whether it will be standalone or attached to another shop. Financial information is also requested, including bank details and questions about the applicant's criminal, tax or bankruptcy history.

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mohit
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238 views2 pages

Bio-Diesel Outlet Application Form

This document is an application for a proposed bio-diesel outlet. It requests personal information from the applicant such as name, address, contact details, as well as details about the proposed outlet such as its name, address, type of business and whether it will be standalone or attached to another shop. Financial information is also requested, including bank details and questions about the applicant's criminal, tax or bankruptcy history.

Uploaded by

mohit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Application Code: YBEPL/__________

Taluka :_______________________________________

District: ______________________________________

________________________________________________________________

Applicant’s Personal Information

Name __________________________________ Father’s Name_______________________

PAN No.________________________________Aadhar No. __________________________

Date of Birth ____________________________Mobile No. __________________________

Landline No. ___________________________ Mail-id_____________________________

Residential Address _________________________________________________________

_________________________________________City:______________________________

Pincode _____________________________ ___State: ______________________________

Details for Proposed Bio-diesel Outlet

Name of the Applicant Firm __________________________________________

Constitution of the firm: Individual/Proprietorship/Partnership/Coop-Society

Office Address_________________________________________________________________
PAN NO_________________________ Rajasthan TIN No ___________________________

Site Address where you want to install bio-diesel outlet:

________________________________________________________________

Proposed for (Stand-alone / Shop-in-shop) _________________________________

Type (Built-up / Green field) ____________________________________________

Site Possession Type: Owned/leased

Site Detail: Area __________([Link].) Dimension : Length ______ft Breadth _______ft

Status of power connection __________________________________________________

Status of water connection __________________________________________

Nearest petrol pump (Name, Company & Address) _______________________________________

Other Important Information

1. Please provide bank details with which main applicant is dealing since last 5 years :

_______________________________________________________________________________

2. Have you ever been convicted of a criminal offence (Yes/No)?


If yes, details ________________________________________________________________
3. Have you ever been convicted of sales tax/income tax/ any type of Government tax
violation ? If yes, details ____________________________________________________
4. Do you have any financial obligations other than those disclosed above (Yes/No)?
If yes, details ________________________________________________________________
5. Have you ever been bankrupt (Yes/No)? If yes, details
__________________________________________________________________________

Place: Signature of Applicant


Date :
NOTE : Individual : Self Attested Copy of PAN Card, Aadhar Card, P Driving License/Passport
(for address proof ), 2 colour photos of Proprietor/Partners/Directors
FIRM / Co-operative Society: Copy of PAN Card, TIN, Cancelled Cheque, Weight &
Measurement Dept Registration (if available)

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