Meeseva Replacement of all existing licenses for Petroleum, LPG and Kerosene Products -Application Form
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Meeseva Replacement of all existing licenses for Petroleum, LPG and Kerosene Products -Application Form:
Replacement of all existing licenses for Petroleum, LPG and Kerosene Products
Product Type*: MS & HSD License/LPG License/Kerosene License
Applicant Details:-
Aadhaar Card No*: _________________________________
Relation*: _____________________________
Is SC/ST/Physically Challenged: Yes No
House No*: _______________________ Street
District*: _________________________ Mandal
Pin Code*: _________________
Business/Service Specific Details
Firm Name*: ________________________________________________
Street*: _________________________ District
Village/Ward*: _____________________________________
Quantity of petroleum products likely to be handled during the current year (KLs):
Quantity of Petroleum products in the possession (KLs):
How long has the applicant been trading in Petroleum products:
Quantity of petroleum products handled annually during the last 3
Godown/Storage address*: _________________________________________________________________________________
Income -Tax paid in the two years preceding the year of applicati
separately):
Year 1*: _____________________________
Year 2*: _____________________________
Informant Details:-
Informant Name*: ____________________________
Mobile No*: ___________________________
Note:
I declare the quantities of Petroleum products specified above are in my possession this day and are
against them.
I have carefully read the conditions of the
and Regulation of Supplies) Order, 2016 and I
Replacement of all existing licenses for Petroleum, LPG and Kerosene Products
MS & HSD License/LPG License/Kerosene License
_________________________________ Applicant Name *: __________________________
________________ Profession*: ______________________________
No
Street*: _______________________________________________________________
____________ Mandal*: ________________________ Village/Ward*: _______
Details:-
________________________________________________ Door No*: _______________________
____________ District*: _________________________ Mandal*: ______________
________________________ Police Station *: ________________________
Quantity of petroleum products likely to be handled during the current year (KLs): ___________________________________
possession (KLs): _________________________________________________________
How long has the applicant been trading in Petroleum products: __________________________________________________
Quantity of petroleum products handled annually during the last 3 years: ___________________________________________
_________________________________________________________________________________
Tax paid in the two years preceding the year of application (to be indicated
___ Amount 1*:__________________________________
_________ Amount 2*: _________________________________
___________________ Relation with applicant*: ____________________
________ Delivery Type*: Manual Local Post Non-Local Post
I declare the quantities of Petroleum products specified above are in my possession this day and are held at the places noted
I have carefully read the conditions of the license given in From 'B' appended to the Telangana Petroleum Products (Licensing
2016 and I agree to abide by them
Replacement of all existing licenses for Petroleum, LPG and Kerosene Products
_____________________
____________________
_____________________________
: ______________________
__________________
____________________
on (to be indicated
___________________
Local Post
held at the places noted
given in From 'B' appended to the Telangana Petroleum Products (Licensing
Document List: - (NOTE: All Upload Documents are in PDF format only)
Application*
Challan Paid *
Security Deposit Paid
Copy of Explosive License*
Copy of NOC issued by the District Administration*
Copy of NOC for Gram panchayat in respect of LPG*
Copy of letter of Intent of oil Company*
Copy of Lease Document*
Copy of VAT License*
Inspector report of concerned*
(NOTE: All Upload Documents are in PDF format only)
Copy of NOC issued by the District Administration*
Copy of NOC for Gram panchayat in respect of LPG*
of Intent of oil Company*
Inspector report of concerned*
Applicant’s Signature