department of food, civil supplies & consumer affairs
TRANSCRIPT
Department of Food, Civil Supplies & Consumer Affairs
Government of Himachal Pradesh
District:_____________________________________ Block:________________________________________
Panchayat:____________________________ Village / Town:________________________________________
New FPS Registra�on Form for ePDS So�ware
Food Instpector Office [Inspector Name]:________________________________________________________
Operated By:______________________________________________________________________________
Lic. / Authority Number:________________________________ Lic. Valid From:_______________________
Lic. Valid To:__________________________________________Shop Type:___________________________Permanent / Temporary
Reserva�on Category:_______________________________________________________________________
FPS Caste Category:__________________________________Godown Name:_________________________
PDC Name:_______________________________________________________________________________
Signature of the Applicant
Ra�on Cards
Popula�on
APL ANTODAYA ANNAPURNA TOTAL
Coop. / Individual / Panchayat / HPSCSC/ Mahila Mandal/ Others
Woman / Handi. / Ex-serviceman / Others
INITIAL RATION CARDS & POPULATION DETAILS
Signature & Seal of the Area Inspector
DISTANCE DETAILS
PUCCA KUCHAPLAIN
BPL
MULE HEAD LOAD CARRIAGE RATE MOTORABLE
General /ST / SC/ Others
FPS Type:____________________________Normal / KeroseneFPS Owner Name:_____________________________________
FPS Owner Permanent Address:_______________________________________________________________
_________________________________________________________________________________________
FPS Status:___________________________
Owner Aadhaar No: Mobile Number:
FPS Shop Name:______________________________________ Ac�ve / Payment Due
SalesMan1
SalesMan2
Mobile Number:DOJName
mm/dd/yyyy
mm/dd/yyyy