Application Number: INS-23-311081(30/06/2023)

Note: 1. This form may be kept for future reference only.

APPLICATION TO ATOMIC ENERGY REGULATORY BOARD (AERB) FOR APPROVAL OF

INSTITUTE REGISTRATION

Application Number : INS-23-311081

Date of Application : 30/06/2023

Institute Details:
Institute Name : RAJYOGAMA JEWELS HALLMARKING CENTRE
Institute Type : Private
Registered with any State/Central Govt auth. : No
Provide Certificate No. :
PAN No. : BKCPM5344J
TAN No. :

Institution Address:
Address Line 1 : CAR STREET, TIRUPADRIPULIYUR
Address Line 2 :
Landmark :
State : Tamil Nadu
City/District : Cuddalore
PIN : 607002

Address of Communication:
Address Line 1 : CAR STREET, TIRUPADRIPULIYUR
Address Line 2 :
Landmark :
State : Tamil Nadu
City/District : Cuddalore
PIN : 607002

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 Application Number: INS-23-311081(30/06/2023)

Contact Details:
Phone (O) : 081 48463606
Email (O) : muru4518@gmail.com
FAX :
Website :

Type of Facility:
Practice : Consumer Products and Scanning Facility
Type of Facility : End User - Consumer Products and Scanning Facility

Employer Details:
Personal Details:
Title : Mr.
First Name : MURUGAN
Middle Name :
Last Name : R
Designation : PROPRIETOR
Date Of Birth : 07/10/1989
Gender : Male
Document/card for proof of identity and date of : PAN card issued by Income Tax Department
birth
Document/card No. : BKCPM5344J
Aadhaar No. :

Residential Address:
Address Line 1 : CAR STREET, TIRUPADRIPULIYUR
Address Line 2 :
Landmark :
State : Tamil Nadu
City/District : Cuddalore
PIN : 607002

Permanent Address:
Address Line 1 : CAR STREET, TIRUPADRIPULIYUR
Address Line 2 :
Landmark :
State : Tamil Nadu
City/District : Cuddalore

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 Application Number: INS-23-311081(30/06/2023)

PIN : 607002

Contact Details:
Phone (O) : 081 48463606
Phone (R) :
Email (O) : muru4518@gmail.com
(This email id will be considered as 'Registered email id')
Mobile(+91) : 8148463606

Attachment Description File Name

Proof of identity and date of birth : Company PAN.jpg
Proof of employership : Proof of employership.pdf
Photo copy of PAN No Of institute : Company PAN.jpg
Photo of TAN No Of institute :
Photo of Adhar No Of employer :
Photo of Government Certificate :
Authentication letter for E-mail Id and Mobile No. : Undertaking.pdf
:

I Acknowledge that:

• Institute registration is one time process.

• I have never registered my institute in eLORA.
• There are options available in eLORA home page for forgot user id, forgot password, forgot contact
details(email and mobile) and to correct the wrongly provided email and mobile.
• Multiple institute registration for the same institute is not allowed by AERB.
• In case, AERB finds multiple institute registration for the same institute in eLORA, appropriate regulatory
action may be initiated against my institute.

With respect to the application for the ‘Application Number’ mentioned above, I hereby certify that,
all the statements made in the application are correct to the best of my knowledge and belief.

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