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Declaration Form
Performa of Declaration for non-receipt of Assessee No. of Business Premises

License Officer,
License Department,
Kolkata Municipal Corporation,
5, S.N. Banerjee Road,
Kolkata 700 013.

Date ……………

Sub: Certificate of enlistment in unassessed premises within Ward No…..

Sir,
I/We/Messrs,……………as Owner/Partners/Director(s), carrying a business as…………… in unassessed premises, hereby declare and consent to the following subject.I/We will not object if the KMC authority withdraw/cancel/change my/our certificate of enlistment due to some legal complexities arising during assessment of the business premises.

Thanking you,
Yours truly,

……………….
Signature with Date


An appeal to the traders of Kolkata: Acquire
your Trade License yourself. Contact and
co-operate with the staff of KMC and help them to
serve you better.

Don't take the help of any tout
to get your Trade License.

Control Room: 2286 1212/1313/1414

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