Application for the …

FORM-IX Application for the grant/amendment/renewal/transfer of a licence to import and store petroleum Documents listed overleaf must be enclosed with this Application , if it is for the grant of a licence in Forms XII, XIII, XIV or in Special From The replies to be given in this column 1. Applicant s name Applicant s calling Applicant s Full postal address _____ _____ _____ 2. Situation of the premises where Petroleum is to be stored , State District Town or Village Police station : Nearest Railway Station _____ _____ _____ _____ _____ 3. Quantity (in liters) of petroleum proposed to be imported and stored : i. Petroleum Class A (a) In bulk (b) Not in bulk (c) Total ii. Petroleum Class B (a) In bulk (b) Not in bulk (c) Total iii.

5. Total of all classes Petroleum: Number of licence held for the premises and the full name of the holder of the licence. I hereby declare that the statements made above have been checked up by me and are true

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