Department of Food, Civil Supplies & Consumer Affairs Government of Himachal Pradesh District:_____________________________________ Block:________________________________________ Panchayat:____________________________ Village / Town:________________________________________ New FPS Registraon Form for ePDS Soware Food Instpector Office [Inspector Name]:________________________________________________________ Operated By:______________________________________________________________________________ Lic. / Authority Number:________________________________ Lic. Valid From:_______________________ Lic. Valid To:__________________________________________ Shop Type:___________________________ Permanent / Temporary Reservaon Category:_______________________________________________________________________ FPS Caste Category:__________________________________Godown Name:_________________________ PDC Name:_______________________________________________________________________________ Signature of the Applicant Raon Cards Populaon 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 KUCHA PLAIN BPL MULE HEAD LOAD CARRIAGE RATE MOTORABLE General /ST / SC/ Others FPS Type:____________________________ Normal / Kerosene FPS Owner Name:_____________________________________ FPS Owner Permanent Address:_______________________________________________________________ _________________________________________________________________________________________ FPS Status:___________________________ Owner Aadhaar No: Mobile Number: FPS Shop Name:______________________________________ Acve / Payment Due SalesMan1 SalesMan2 Mobile Number: DOJ Name mm/dd/yyyy mm/dd/yyyy
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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
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