Application for the grant/amendment/renewal/transfer

of a licence to import and store petroleum.

Documents listed overleap must be enclosed with this application, if it is

for the grant of a licence in Forms XII,XIII, XIV or in special Form.

  The replies to be given   in this column.

1.       

Applicant’s name

Applicant’s calling

Applicant’s Full postal address

 

2.       

Situation of the premises where petroleum is to be stored

State

District

Town or village

Police Station

Nearest Railway Station

 

3.       

Quantity (in litres) of Petroleum proposed to be imported and stored.

(i)                  Petroleum class A

(a)     In bulk2

(b)     Not in bulk2

(c)     Total

(ii)                Petroleum Class B

(a)     In bulk2

(b)     Not in bulk2

(c)     Total

(iii)               Class C

(a)     In bulk2

(b)     Not in bulk2

(c)     Total

 

4.       

Quantity in litres of petroleum already stored in premises.

(i)                  Petroleum Class2

(ii)                Not in bulk2

(iii)               Total

 

(ii) Petroleum Class B

(a)     In bulk2

(b)     Not in bulk2

(c)     Total

 

(iv)              Petroleum Class C

(a)     In bulk2

(b)     Not in bulk2

(c)     Total

Total of all classes of Petroleum already stored.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.T.O

5.       

Number of the license held for the premises and the full name of the holder of the licence.

 

I hereby declare that the statements made above have been checked up by me and are true and I under take to abide by the terms ad conditions of the licence which will be granted to me.

 

Date of Application :                                                                 Signature & designation of the applicant

                                                                                             

 

1.      Where the application is made on behalf of a company, the name and address of the company and the name of the manager or agent should be given and the application should be signed by him. Every change in the name o the Manager or agent shall be forthwith intimated to and his specimen signature filed with the licensing authority.

 

2.      “In bulk” means in tanks or receptacles exceeding 1000 litres in capacity. Not in bulk means in approved containers not exceeding 1000 litres in capacity.