APPLICATION FORM FOR REGISTRATION/RENEWAL AS A DEALER
FORM I
(See Rule 3)
To,
The Prescribed Authority
Sir,
I/We request that I/We may be registered as a dealer within the meaning of Goa, Daman and Diu
Registration of Tourist Trade Act, 1982 for ……………. in respect of the articles mentioned in the
Annexure to this application. The other particulars of my/our business are mentioned below;
1. Name of the dealer with
full address in the tourist
area
:
2. Name of the business
concern.
:
3. Permanent residential
address.
:
4. Name of the Proprietor(s). :
5. Name of the Agent /
agents / Employee(s).
:
6. Nature of business. :
7. Date of establishment of
the business concern.
:
8. Date of submission of the
application.
:
9. Tourist area in which the
applicant is desirous to
carry on the business.
:
10. Whether the applicant is
a permanent resident of
Goa, Daman & Diu.
:
11. Any other business which
the applicant is carrying
on in any tourist area in
the Union Territory of
Goa, Daman & Diu or
outside the Union
Territory.
:
(Signature of the
Applicant)
Place:
Dated:
Note:
i. The dealer should append an annexure indicating therein the articles regarding which he wants to be registered.
ii. The application should be supported by a certificate verifying the above particulars from the Municipal Council/Village Panchayat.