FORM `J` [See rule 26 (1)] To The Secretary, Agricultural Produce

FORM ‘J’
[See rule 26 (1)]
To
The Secretary,
Agricultural Produce Market Committee
Sir,
The particulars of my business are given below:—
1.
Name of the applicant with parentage, residence and address in full._______________
__________________________________________________________________________
2.
3.
4.
Sr. No.
1
If the applicant is a firm, is it a Hindu Joint Family Firm, or otherwise constituted. ___
________________________________________________________
Has it been registered or not? _____________________________________________
If the applicant is a firm, give the names of all persons constituting it with parentage,
residence and address, in full of each:
Name
2
Fathers/Husband’s name
3
5.
Name of the Managing proprietor or the Manager who will actually conduct the business
6.
Name or style under which the applicant will conduct his business
7.
Does the applicant wish to be registered as a broker/ weighman/ measurer/ surveyor/ godown
keeper/ hamal (Palledar)_
9. Has the registration, if any, made previously to the applicant, or if the applicant is a firm, to any
member thereof, singly or in collaboration with anybody else, for working as a broker, weighman,
measurer, surveyor, godown keeper or hamal (Palledar) in any notified market area been cancelled.
If so, where, when, for what period and for what reason?
Certified that :—
(i) the facts set out in application are true to the best of my knowledge.
(ii) I under take to abide by provisions of the Himachal Pradesh Agricultural and
Horticultural Produce Marketing (Development and Regulation) Act, 2005 (Act No. 20
of 2005) and rules and bye- laws made there-under,
(iii) I shall be responsible for all acts of my employees.
It is, therefore, requested that the registration certificate under section 40 of the Himachal Pradesh
Agricultural and Horticultural Produce Marketing (Development & Regulation) Act, 2005 may kindly be
issued to me.
Dated.................
Signature of the Applicant
Notes,—
(1) Registration to work as a weighman, a measurer or a surveyor shall only be issued to individuals
and not to a firm.
(2) In case the application is made by a firm, it may be signed by the Managing proprietor only.
To be filled in by office
Registration fee
received
1
No and date
of receipt
2
Page of cash book
where entry made.
3
Contents of application verified.
Market Supervisor,
I/c of the Market Area/ Market yard.
Accountant
Committee
Orders of Registration Authority
Date:
Signature with Designation.