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Application for Health Trade License

 
Application for Health Trade License
  (Fields marked * are mandatory)
APPLICANT DETAILS
Applicant Name *   (Max length 25 chars) Applicant Father/Husband Name *   (Max length 25 chars)
Upload Photograph *    
Applicant Address *  (Max length 255 chars) Upload Establishment Photograph *  
CLASSIFICATION OF TRADE
Trade Description * Nature of Trade in detail *
 
 
ESTABLISHMENT DETAILS
Name of the Unit / Establishment   (Max length 50 chars) Year of Establishment   (Max length 50 chars)
VAT No.   (Max length 50 chars) TIN No.   (Max length 50 chars)
Pan Card Number   (Max length 50 chars)  
ADDRESS OF UNIT
Premises / Property No. *   (Max length 30 chars)  
Locality *   (Max length 30 chars) Pin code * 110   (Max length 3 chars)
Trade Area Type*
Phone (Mobile) *   (Max length 10 chars) E - Mail   (Max length 50 chars)
(Pl provide your email id so that System will mail your application ref number)
Electric Connection Number *   (Max length 30 chars) Colony *  
TYPE OF CONSTITUTION
Type of Constitution *
S.No. Name Voter ID/Aadhaar No Address
1
 
PROPERTY DETAIL(UNDER USE IN BUSINESS)
On which floor the unit is situated *
(Please press ctrl and mouse click for multiple selection)
Covered Area of Floor *   (Max length 30 chars)
Ownership *  
Is the Structured Protected Under the Delhi Special Provision Act 2011/14 *  Yes  No  
Unit Area in Sq.Mts *   (Max length 30 chars)  
DETAILS OF MUNICIPAL TAXES/OTHER TAXES(if any)
Whether Property Tax Paid?  Yes  No Whether Conversion Charges Paid?  Yes  No
ENCLOSURES / ATTACHMENT * Hereby applicant requested to upload self attested copies of all the documents
* Documents with maximum size of 2 MB can be uploaded. The supported formats are JPEG, GIF, DOC, ZIP, RAR and PDF
      Document Expiry Date
1 One copy if site plan and key plan on normal paper duly signed by applicant  
2 Indemnity bond on non judicial stamp paper of Rs 100/ duly notarized  
3 Proof of legal occupancy (Sale Deed/Lease Deed/Rent Agreement/latest rent receipt) ownership by will/gift deed