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: 30250105118684733 Application Type: New Registration
Name of Applicant / DYNASTY CAFE AND Application Date: N/A
Company: RESTAURANT Kind of Business: Trade/Retail - Storage
Designation: Proprieter (Cold / Refrigerated),
Trade/Retail - Retailer,
Food Services -
Restaurants
Address of Premises Where Food Business Is Located
Address: Bidyapur, Ward no State: Assam
7, Po - Bidyapur
Sub-Division/Station/ Nalbari Sadar Sub-
District/Region/Zone: Nalbari Division(Railways): Division
Village: Nalbari Town Pan No: AQUPD1929K
Pin Code: 781335 Name: RAKESH DUTTA
Nearest Landmark: Nalbari collage DOB: 09-04-1990
Gender: MALE
Correspondence Address Details
Address: Vill Terechia, po - State: Assam
Terechia Sub-Division/Station/ Nalbari Sadar Sub-
District/Region/Zone: Nalbari Division(Railways): Division
Village: Terechia Pin Code: 781334
Contact Details
Telephone No: N/A Fax: N/A
Mobile No: 8812807078 Email-ID:
[email protected]Contact Person: RAKESH DUTTA om
Aadhaar No: 48XXXXXXXX38
Other Details
In case of New business – intended date of start: 01-03-2025
Source of Water Supply: Private
Sanction Electricity Load or HP Used: No
Number of years applied for: 2
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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. Name of the food category
No
1 15 - Ready-to-eat savouries
2 02 - Fats and oils, and fat emulsions
3 03 - Edible ices, including sherbet and sorbe
4 04 - Fruits and vegetables (including mushrooms and fungi, roots and tubers, fresh pulses and
legumes, and aloe vera), seaweeds, and nuts and seeds
5 08 - Meat and meat products, including poultry and game
6 09 - Fish and fish products, including molluscs, crustaceans, and echinoderms
7 16 - Prepared Foods
8 10 - Eggs and egg products
9 13 - Foodstuffs intended for particular nutritional uses
10 14 - Beverages, excluding dairy products
11 11 - Sweeteners, including honey
12 12 - Salts, spices, soups, sauces, salads and protein products
13 18- Indian Sweets and Indian Snacks & Savouries products
14 100 - Standardised Food Product excluding those covered under category 1-14
15 99 - Substances added to food
16 05 - Confectionery
Document(s) Details
S.No. Documents Description Uploaded Document
Other Document(s) Details
S.No. Documents Description Uploaded Document
No Record Found
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,
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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."
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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