FSSAI declaration and nominee letter (Form IX sample)

DECLARATION AND NOMINATION OF PERSON (Sample for Form IX, Food Safety and Standards Act, 2006) Name of the food business: ________ Address of the food premises: ________ Kind of food business: ________ FSSAI application number: ________ PART 1. NOMINATION We, the undersigned, nominate ________, son, daughter or wife of ________, working as ________, resident of ________, as the person responsible for making sure that the food business at the above premises follows the Food Safety and Standards Act, 2006 and its rules and regulations. The nominee is authorised to sign and submit applications and returns on behalf of the business, to receive notices and orders from the Food Safety department, and to deal with the officers of the department. PART 2. DECLARATION I, ________, ________ of ________, declare that: 1. All the information given in the application for an FSSAI licence or registration is true and correct. 2. The business will follow the Food Safety and Standards Act, 2006 and the rules and regulations made under it, including the hygiene and safety standards for the premises. 3. The business will not sell or store any food that is unsafe, adulterated, misbranded or banned. 4. The business will keep the licence or registration number displayed at the premises and on its bills, and will renew or update it as required. 5. We will tell the Food Safety department if the nominee changes. Date: ________ Place: ________ Signature of the person signing for the business: ______________________ Name: ________ ACCEPTANCE BY NOMINEE I, ________, accept this nomination. Signature of nominee: ______________________