SELF - DECLARATION FOR PROPRIETORSHIP FORMAT FOR APPLICATION OF FSSAI LICENSE

Download self-declaration format for proprietorship FSSAI license application. Mandatory for individual food business owners to meet FSSAI compliance requirements.

SELF - DECLARATION FOR PROPRIETORSHIP

(To be used for establishing proprietorship status)
(To be printed on Letterhead of the Firm)

I, [Full Name of Proprietor], S/o / W/o / D/o [Spouse’s/Father Name], do hereby state and affirm as follows:

R/o [Residential Address]

 

1. I am the sole owner/proprietor of a business operating under the name and style “[Business Name]”, operating from [Start Date].

2. This business is not undertaken/operated by a partnership firm or limited liability company.

3. It is also declared that the below-mentioned person is my legal nominee for the said proprietorship concern:

   Name: [Nominee’s Full Name]

   Relationship with the proprietor: [Relationship]

4. That the contents of this declaration are true and correct to the best of my knowledge and belief.

 

Signatures of the Proprietor with Stamp/Seal

 

Name: [Proprietor’s Name]

Place: [City]

Address: [Full Address]

Date: [DD MMM YYYY]

Contact No: [Phone Number]