DRAFT OF LIST OF MEMBERS FOR APPLICATION OF FSSAI LICENSE

Download the draft format of List of Members required for FSSAI license application. Includes name, address, contact, ID proof, and appointment date in editable Word format.

List of Members, Society/Trust (w.e.f. DD/MM/YYYY)

On the Letterhead of the Society/Trust

Sl. No.

Name of the Director/Executive Members*

Address*

Contact No.*

ID Details (Govt. Issued Photo ID)

Date of Appointment (DD/MM/YYYY)

1

Mr/Mrs/Miss

 

 

 

DD/MM/YYYY

2

Mr/Mrs/Miss

 

 

 

DD/MM/YYYY

3

Mr/Mrs/Miss

 

 

 

DD/MM/YYYY

4

Mr/Mrs/Miss

 

 

 

DD/MM/YYYY




Signature of the Authorised Signatory
(Along with Seal of Trust/Society)