West Bengal Pollution Control Board
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Lead Acid Battery Administration

APPLICATION FORM FOR REGISTRATION
(Please Provide the following information)
 
 
GENERAL INFORMATION
 
Name of the Unit :*
Please Tick Your Activities :* Dealer Importer Bulk Consumer Auctioneer Registered Recyclers Manufacturer
 
 
For Dealers : For Importers :
TIN/VAT number : Import/Export License number :
For Recyclers : Import/Export License holder name :
Installed annual capacity to recycle (in MTA) : MoEF/CPCB Registration No. :
 
 
Unit Address :
Plot No :* Building Name :
Road:* City/Town/Village:*
Police Station:* Local Body:*
Ward Number:* District :*
Post Office :* Pin Code :*
Telephone No. :* Fax :
Email:* Website:
 
 
Name of Applicant:* Designation of Applicant:
Mobile No. :*
Correspondence Address :   Same as unit address
Plot No :* Building Name :
Road:* City/Town/Village:*
Police Station:* Local Body:*
Ward Number:* District :*
Post Office :* Pin Code :*
Telephone No.:* Fax:
Email:*
Date of Application (DD/MM/YYYY):
 
AUTHENTICATION
 
Please memorise the password and the registration number for future communication. This is Important
 
Enter Password :* Repeat Password :*