Application form for License for Sales of Crackers

Service Specific Details

Application Processing Location/ District Administration where the application is being submitted *

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Licence Type *

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Application Type *

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Firm/Person in whose name the License is required *

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Purpose of Licence *

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Licence to possess and sell from a shop at anytime, not exceeding 100 kilograms of manufactured fireworks of class 7, division 2, sub division 2, and 500 kilograms of Chinese crackers or sparklers

Licence to possess and sell from a shop manufactured firework of class 7, division 2, sub division 2 exceeding 100 kilograms but not exceeding 300 kilograms and Chinese crackers or sparklers exceeding 500 kilograms but not exceeding 1200 kilograms

Licence to possess and use fireworks for public display

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Fee Payable

Applicant's Personal Details

Salutation *

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Full Name *

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Gender *

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Landline No. *

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E-Mail *

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Mobile Number *

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Upload a passport sized photograph *

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Name of the Business or Shop *

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Relative Details:

Son of/ Daughter of/ Wife of *

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Salutation of Father/Husband *

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Full Name of Father/ Husband *

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Applicant's Address Details

Present Address of the Applicant :

House No./House Name/Landmark *

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Town/City/Village *

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PO/PS *

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Country *

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State *

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District

Postal / Zip Code *

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Permanent Address of the Applicant :

Same as the present address? *

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Yes

No

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House No./House Name/Landmark *

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Town/City/Village

PO/PS *

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Country *

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State *

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District

Postal / Zip Code *

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Situation of Premises/ Address of Business Locations

Address Details *

Landmark/ Building Name *

Village/ Town/ City *

District *

Pincode *

Mobile Number *

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Explosive proposed to be possessed and sold

Details of Explosives *

Name *

Description *

Class *

Division, if any

Quantity at any one time *

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Division, if any

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Qualification and Experience of the Applicant and the Technical Personnels employed

No of Technical Personnel employed *

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Name *

Qualification *

Experience *

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Other Details

If explosives are to be used, furnish the purposes of use *

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Whether convicted under any offence or ordered to execute any bond under chapter VIII of the code of criminal procedure , 1973 during last 10 years *

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Yes

No

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Give Details *

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Whether the Applicant has been issued any other license under Explosives Act, 1884 during the last 10 years, if any *

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Yes

No

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Details of previously issued license

Name of License *

License No. *

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Was any license cancelled/ Not Renewed *

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Yes

No

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Name of License *

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License Number *

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Cancellation Date of License *

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The Licensed Premises shall conform to the following drawing(s) details

Drawing Details *

S. No *

Drawing No. *

Date

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Date

Details of the Licensee from whom the fireworks will be obtained for Display/ Use

Quantity of fireworks to be used *

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Name of Licensee *

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License No. *

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License Issuing Authority *

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License Validity *

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Address *

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Location of the Place where the Firework will be stored prior to display

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Quantity of fireworks to be displayed *

(Date of Display) From *

To *

Location of the Place where display will be held *

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Declaration

I, do hearby declare that the facts and contents given below are true to the best of my knowledge and belief.

1) Use of firecrackers shall be restricted to certain distinguished places/open area only.
2) The firework/firecrackers shall be kept in the shed made of non-flammable material.
3) The sheds for the possession and the sale of fireworks shall be at a distance of 3 meters from each other.
4) No shed shall be facing to each other.
5) No oil burning lamps, gas lamps shall be used in the shed or within the sefely distance of sheds for the purpose of lighting. Any electrical light if used shall be fixed to wall or ceiling. No flexible wire shall be suspended.
6) The keep fire extinguishing equipment and material like sand, water etc. in the shed to combat any emergency.

I Agree *