Application for issue of Trade License (Health related Trades)

UBIN Details

UBIN *

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Select Office *

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I. DETAILS OF THE TRADE/OWNER

(a) Applicant's Name

(b) Applicant's PAN CARD Number

Name of trade / shop

Owner’s Type

Owner’s Name

Father’s / Spouse’s name

GMC Zone/ Ward No.

(a) Applicant's Date of Birth :

(b) Applicant's Age :

Address of the Trade

Street name 1 *

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Street name 2

Town/Vill

Country

State

District

Postal / Zip Code

Block/Ward No.

Address of the Owner

Street name 1 *

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Street name 2

Town/Vill

Country

State

District

Postal / Zip Code

Mobile Number

II. TYPES OF PREMISES

Type of premises ?

GMC Holding No.

Owner’s Name

(a) Rent Per Month

(b) Does premises have parking space ?

Owner’s Residence Address

III. GODOWN EXISTS

Does Godown Exist in the same premises ?

IV. OLD TRADE LICENSE DETAILS

Do you have existing Trade License ?

V. OTHER DETAILS

Type of Business

Capital Investment

Annual Income for the previous financial year (in Rupees)

Income Tax Payable / Paid for the previous financial year (in Rupees) :

License:(Regural /Provisional (1 Year))

Date