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.
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1.
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Applicant’s
name Applicant’s
calling Applicant’s
Full postal address |
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2.
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Situation
of the premises where petroleum is to be stored State District Town
or village Police
Station Nearest
Railway Station |
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3.
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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 |
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4.
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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 |
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5.
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Number
of the license held for the premises and the full name of the holder of
the licence. |
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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
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.