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NEW FERTILIZER REGISTRATION CERTIFICATE APPLICATION
STEP:
1
/3
DETAILS ABOUT FRC ISSUING AUTHORITY
Notified Authority :
(*)
District Agriculture Officer
District :
(*)
--Select--
ANGUL
BALASORE
BARGARH
BHADRAK
BOLANGIR
BOUDH
CUTTACK
DEOGARH
DHENKANAL
GAJAPATI
GANJAM
JAGATSINGHPUR
JAJPUR
JHARSUGUDA
KALAHANDI
KENDRAPARA
KEONJHAR
KHURDA
KORAPUT
MALKANGIRI
MAYURBHANJ
NABARANGAPUR
NAYAGARH
NUAPADA
PHULBANI
PURI
RAYGADA
SAMBALPUR
SONEPUR
SUNDERGARH
DAO Office:
(*)
--Select--
APPLICANT'S INFORMATION
Bussiness Type :
(*)
Wholesale Dealer
Retail Dealer
Dealership Nature :
(*)
--Select--
Private Wholsaler
Private Retailer
PACS
State Marketing Federation
District Cooperative Marketing Society
Manufacturer Outlet
Registered Agricultural Coperative
Applicant's Name :
(*)
Name Of Firm
(*)
Postal Address :
(*)
District :
(*)
--Select--
ANGUL
BALASORE
BARGARH
BHADRAK
BOLANGIR
BOUDH
CUTTACK
DEOGARH
DHENKANAL
GAJAPATI
GANJAM
JAGATSINGHPUR
JAJPUR
JHARSUGUDA
KALAHANDI
KENDRAPARA
KEONJHAR
KHURDA
KORAPUT
MALKANGIRI
MAYURBHANJ
NABARANGAPUR
NAYAGARH
NUAPADA
PHULBANI
PURI
RAYGADA
SAMBALPUR
SONEPUR
SUNDERGARH
Block :
(*)
Pin:
(*)
State :
(*)
Mobile No:
(*)
Telephone No :
Email-ID:
(*)
Fax No :
PAN Number:
TIN/SRIN Number:
Photograph:
(*)
(in .jpg/.jpeg/.bmp/.gif only)
All * Marked Fields Are Compulsory.....
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