Brochure

For

Selection of

Non Domestic LPG Distributors

(Revised)

July 2019

Page 1 of 16
 SELECTION GUIDELINES FOR APPOINTMENT OF NON-DOMESTIC LPG DISTRIBUTORS

ELIGIBILITY CRITERIA

The applicant should:

i. Be an Indian citizen and be a resident of India.

ii. Have minimum 10th Pass as educational qualification awarded by any of the recognised board incorporated by an Act of
the Central or State Legislature in India or any other educational institutions established by state/ central legislature
bodies or possess an equivalent qualification recognized by the Ministry of HRD, Government of India as on the last
date for submission of application, as specified in the advertisement or corrigendum (If any)

iii. Be not less than 21 years and not above 60 years (in completed years) as on the last date for submission of application,
as specified in the advertisement or corrigendum (If any)

iv. Applicant should not be a ‘family member of an employee of Oil Marketing Companies’ as on date of application.

Family member of an employee of Oil Marketing Companies means:

(i) The wife or husband as the case may be of the employee, whether residing with him / her or not, but does not
include a wife or husband as the case may be separated from the employee by a decree or order of a competent
Court. Sons or daughters or step-sons or step-daughters of the employee and wholly dependent on him, but
does not include a child or step-child who is no longer in any way dependent on the employee or of whose
custody the employee has been deprived by or under any law.

(ii) Any other person related whether by blood or marriage to the employee or to such employee’s wife or husband
and wholly dependent on such employee.

v. Fulfil Multiple Dealership/Distributorship norms, which means the applicant or any other member of ‘family unit’ should
not hold a Dealership/LPG Distributorship or Letter of Intent (LOI) for a Dealership/LPG distributorship of any PSU Oil
Marketing Company.

Multiple Dealership / Distributorship norms means the applicant or any other member of ‘family unit’ should
not hold a dealership/LPG distributorship/ or Letter of Intent (LOI) for a dealership/LPG distributorship of any type of a
PSU Oil Company i.e., only one Retail Outlet / SKO-LDO dealership / LPG distributorship of a PSU Oil Company
will be allowed to a ‘Family Unit’. However, existing SKO dealers of OMCs operating below an average allocation
of 75 KL of SKO per month during the immediate preceding 12 months prior to the month of advertisement will be
eligible to apply and if selected will have to surrender their Kerosene dealership prior to issuance of letter of appointment
for Non Domestic Distributorship. The SKO dealer applying for Non Domestic Distributorship LPG Distributorship
will have to submit documentary proof of Kerosene allocation issued by the allocating authority of the State
Govt./Divisional/Territory/Regional Office of the Oil Marketing Company, as the case may be.

Family Unit for multiple dealership / distributorship norm means the following:

i. In case of married person/ applicant, ‘Family Unit’ will consist of individual concerned, his/her Spouse and
their unmarried son(s)/daughter(s).
ii. In case of unmarried person/ applicant, ‘Family Unit’ will consist of individual concerned, his/her
parents and his/her unmarried brother(s) and unmarried sister(s).
iii. In case of divorcee, ‘Family Unit’ will consist of individual concerned, unmarried son(s)/unmarried
daughter(s) whose custody is given to him/her.

Page 2 of 16
 iv. In case of widow/widower, ‘Family Unit’ will consist of individual concerned, unmarried
son(s)/unmarried daughter(s).

vi. Candidate should provide details of Godown / land for Godown (on ownership / Registered Lease for a minimum period
of 5 years) in his/her name or in the name of Family Unit / Offer letter for godown land on applicant’s name for minimum
period of 5 years at the time of submission of application. The LPG Godown should be of minimum 2000 Kg capacity
(and to be located within 25 kms from municipal/ town/ village limits of location advertised.

The Own / registered lease deed for minimum 5 years of Godown/ land for construction of Godown includes
ownership of the “Family Unit” / parents (includes Step Father/ Step Mother), Grandparents (Both Maternal and
Paternal), Brother/ Sister (Including Step Brother & Step sister), Son/ Daughter (including Step Son/ Step
Daughter), Son in- law/ Daughter in –law of the applicant or the spouse (in the case of married applicant) as on
the last date of application as specified in the advertisement or corrigendum if any.

In case of offered land for godown / constructed godown, the same has to be registered on sale deed / lease deed on
candidate name / family unit, before issuance of the LOI. The candidate who has submitted LAND ON OFFER in the
application has to be intimated, for registration of the land after successful completion and approval of FVC. The
registration of land has to be completed within two months of intimation.

vii. Godown land should meet the minimum dimensions of 17m x 13m and meeting all the requirements of PESO for
obtaining license capacity of 2000 KGs. For more details please refer to PESO office / website: www.peso.gov.in. The
land for construction of godowns should be plain, in one contiguous plot, free from live overheads, power transmission
or telephone lines. Canals/ drainage/ nullahs should not be passing through the plot.

viii. Selected candidates should provide a valid PESO licence and other statutory approvals of Central and State Governments
as applicable for LPG Godown within 4 months of issuance of LOI.

ix. While there is no minimum requirement of finance to be declared by applicant as on the date of application, the candidate
should have adequate amount to cover the security deposit towards equipment’s (cylinders/ DPRs etc.) to be issued to
him/her on selection and commencement

x. The candidate is required to make available office space and infrastructure for storage of files, Customer data, Facility
to communicate with customers by way of emails, telephone etc. as well as place for Distributor staff to be available for
the customers. The distributor is also required to have / appoint staff with technical expertise who can assist customers
with respect to use of Commercial LPG/ Conversions etc.
xi. The candidate should neither have been convicted nor charges been framed by any Court of Law for any criminal offence
involving moral turpitude/ economic offences.

xii. The candidate should not have been a signatory to distributorship/dealerships agreement, terminated on account of proven
cases of malpractice of any Oil Company.

xiii. Totally paralysed, mentally unsound and totally blind persons are not eligible to apply for any distributorship.

PARTNERSHIPS:

In case of partnership, each partner should individually meet the specified eligibility criteria and should also submit
separate application forms along with separate application fee. However, the applications should be clubbed together. If
called for interview, all of them must appear for interview. They also have to submit a copy of the partnership deed along
with the application.

Page 3 of 16
 PERSONAL SUPERVISION BY DISTRIBUTORS:

A person selected for the distributorship shall be paying attention towards day to day working of the distributorship by
effectively managing the affairs of the distributorship.

APPOINTMENT PROCEDURE

Locations would be identified by assessing the potential for Non Domestic LPG business by the Territories and Regions.
Non Domestic LPG distributors will also be allowed to do BMCG, FTL cylinders, HIPPO cylinders as well as any new
initiative business catering to the Non -domestic sector. Supply of domestic LPG cylinders will not be allowed through
the non-domestic LPG distributorship.

ADVERTISEMENT:

The locations identified as above to be advertised in a local daily newspaper having wide circulation in the said district.
(English or vernacular) .The format for advertisement will be as per Annexure A.

APPLICATION FORM:

Application form for distributorship will be available for download free of cost from our website www.ebharatgas.com
and www.bharatpetroleum.in.

a) The application can be submitted on plain paper in the prescribed format as mentioned above.

b) Application Fee: (nonrefundable) - Rs.1000/-. ( Rs.500/- for SC/ST candidate) in form of Demand Draft drawn in
favor of BHARAT PETROLEUM CORPORATION LIMITED payable at location of the concerned territory as
mentioned in Advertisement /Brochure.

c) The application form completed and signed by the candidate along with Application fee is to be submitted at
concerned Territory office as mentioned in Advertisement latest by 5 PM on the last date for submission of application,
as specified in the advertisement or corrigendum (If any). SC/ ST candidates have to provide certificate from competent
Authority along with the application.

d) The selected candidate after due procedure is to submit an FVC (Field Verification credential ) fee of Rs. 10,000/-
(non-refundable) by Demand Draft drawn in favor of BHARAT PETROLEUM CORPORATION LIMITED payable at
location of the concerned territory as mentioned in Advertisement /Brochure within 7 days of selection failing which
the candidature shall be cancelled and selection process shall proceed further.

e) In case of partnership, each partner shall have to submit separate application forms along with separate application
fee as applicable. However, while submitting the filled forms their application forms have to be attached together.

GENERAL:

I. The selected Non-domestic distributors appointed will enroll with their own efforts the nondomestic customers and
no existing non-domestic customers will be transferred to them from existing LPG distributor network.

II. The Non-domestic distributor selected will be for Non-domestic packed cylinder supplies and neither now nor in
future will be allowed to enroll domestic cylinder customers and effect supplies.

III. The company reserves the right to cancel / withdraw / amend this advertisement or extend the due date at its sole
discretion without assigning any reason.

IV. No addition /deletion/ alteration will be permitted in the application once it is submitted.

Page 4 of 16
 V. Applications received after the cut-off date including postal delay, and those without accompanying valid documents
including application fee or incomplete in any respect will not be considered and no correspondence will be
entertained by BPCL in such cases whatsoever

VI. In respect of all documents /certificates; only self-attested copies are to be attached along with the application.
Originals of such documents / certificates will have to be brought at the time of interview.

VII. Applicants willing to apply for more than one location can do so in separate application form and should enclose
separate DD/pay order as application fee.

VIII. If any statement made in the application or in the document enclosed therewith or subsequently submitted in pursuance
of the application by the candidate at any stage found to be incorrect or false, the application is liable to be rejected
without assigning any reason and in case the applicant has been appointed as a Non- Domestic distributor, the
distributorship is liable to be terminated. In such cases the Non-domestic distributor shall have no claim whatsoever
against BPCL.

IX. This is purely a business proposition and not an application for job in BPCL and has normal business risks and also
do not guarantee any assured returns or profits.

X. This is only an application and not an offer of Non-Domestic distributorship.

Applications submitted without application fees and/or received after the specified closing date and time including postal
delay will not be entertained.

CUT-OFF DATE FOR RECEIPT OF APPLICATIONS:

The advertisement should specify the last date on or before which the applications are to be submitted. The cut-off date
should be minimum 30 days from the date of publication of the advertisement in the newspapers i.e. it should be ensured
that the applicants get a minimum of 30 days clear time for submission of completed application. It should be ensured
that the date specified in the advertisement is a working day for BPC. The same principle applies for release of
corrigendum.

PROCEDURE FOR RECEIPT OF APPLICATION

Application to be received in sealed envelope only. The date of receipt of application should be stamped on the envelope
containing the application. In case of applications are received late, proof of late receipt should also be retained and
application should be returned to the applicant immediately. List of applicants whose applications were received late and
returned should be maintained location wise at concerned Territory Office.

FINALISATION OF MERIT PANEL:

i. The selection committee will prepare a panel of 3 candidates in order of merit and the same will displayed on the notice
board immediately after completion of the interviews of the location as per format

ii. The merit panel finalized will be made in duplicate and signed by all the members of the committee. One copy of the
merit panel list and the mark sheet will be handed over to the co-ordinator of the Territory by the committee in sealed
envelope. This sealed envelope shall be kept in record as it is. The other copy of merit panel in a sealed envelope will
be sent to the concerned RLM within 24 hrs by the co-ordinator.

iii. The co-ordinator will post the Merit Panel on the notice board at the venue immediately on completion of the interview
and also host the Merit Panel on the website with 7 days of completion of interview.
Page 5 of 16
LETTER OF INTENT:

The candidate select, after receipt of LOI should fulfill the conditions specified in the LOI within a period of four months
from the date of LOI or the time given by the OMC, failing which the LOI is liable to be withdrawn along with forfeiture
of the amount remitted by the selected candidate before FVC.

VALIDITY OF MERIT PANEL:

Validity of merit panel of candidates for distributorship ceases to exist once the distributorship is commissioned.

GRIEVANCE /COMPLAINT REDRESSAL SYSTEM

1. Anonymous complaints will normally not be investigated.

2. Complaint should be accompanied with a non -refundable fee of Rs 10,000 by demand draft.

SECURITY DEPOSIT :

The selected candidate, before being issued the appointment letter should have to deposit interest free refundable Security
Deposit of Rs. 5 lakhs to the company.

BPC will reserve the right to adjust any dues to it from this amount at the time of resignation/ termination. However, in
case of termination of the distributorship is on account of proven malpractice, the said security amount shall be forfeited.

TENURE OF DISTRIBUTORSHIP

The tenure of the distributorship shall be for an initial period of 5 years and renewable for every 5 years thereafter, subject
to the examination of the performance of the distributorship by the Territory and Region and decision thereon.

FALSE INFORMATION
If any statement made in the application or in the documents enclosed therewith or subsequently submitted in pursuance
of the application by the candidate at any stage is found to have been suppressed / misrepresented / incorrect or false
affecting eligibility, then the application is liable to be rejected without assigning any reason and in case the applicant
has been appointed as a distributor, the distributorship is liable to be terminated. In such cases the candidate / distributor
shall have no claim whatsoever against the respective Oil Company

SELECTION PROCESS & EVALUATION CRITERIA

The LPG Non Domestic distributor for the advertised location will be selected on the basis of interview of all eligible
applicants. The date of interview will be individually informed to the eligible applicant by an interview call letter.
Each candidate appearing in the interview will be assessed by the selection committee broadly under the following
parameter.

Page 6 of 16
NORMS FOR EVALUATION FOR NON –DOMESTIC LPG DISTRIBUTORS

Sr. Parameter Description Max Evaluation

No. Marks
1 Age 46 yrs and above 8 Marks will be awarded based on
proof of age produced at the time
21- less than 46 years 10 of interview
Sub Total maximum marks 10
2 Educational a) 10th pass from government recognised 15 Marks will be awarded based on
Qualification institution proof of educational qualification
produced at the time of interview
b) Graduate and above 25

Sub Total maximum marks 25

3 Infrastructure Godown – Owned (Constructed 50
Godown meeting eligibility criteria).
Own Land for Godown (clear title of 40
ownership) or Registered Lease.
Marks will be awarded based on
information provided in the
application

Offer for constructed godown / land 30

for godown meeting eligibility criteria.
Sub Total maximum marks 50
4 Business ability / Assessment will be done on the 5 Marks will be awarded based on
acumen following:- response to specific situation
related queries/questions on the
- Management of people
following:-
- Management of finance
-Management of people
-Management of material &
-Management of finance
infrastructure
-Management of Material &
-Trade related
infrastructure
-Trade related
Sub Total maximum marks 5

Page 7 of 16
 5 Experience Direct Sale / Associated
Industrial Gas , Hotels.
Other Petroleum products, FMCG, 4
other retailing business.
with 5 Marks will be awarded based on
proof of experience produced at
the time of interview. Minimum
experience of 1 year as on date of
application.

Marks will be awarded on the

quality rather than amount of
experience. The quality of
experience will be judged based
on the response to the questions
related to experience in Direct
Sale, Home Delivered products,
Trade of petroleum products,
Hospitality /service industry
Any other Trade 2 etc by the candidates in the
interview.

Sub Total maximum marks 5

6 Personality Assessment on the following 5 Assessment based on observation
parameters Communication and leading questions.
/articulation skills. Polite, presentable
and well mannered. Enthusiasm /
energetic / Self- confidence /
convincing power.
Sub Total maximum marks 5
Grand total 100

In respect of partnerships, all partners will have to attend the interview and they will be evaluated as under: -

Under parameters age, educational qualification, experience, business ability/acumen and personality, partners will be
evaluated individually. Marks obtained by each partners in these parameters will be added and averaged to arrive at the
marks obtained by the partnership firm.

In case of tie between two or more candidates i.e. same total marks, then to decide the merit ranking, the applicant who
has scored higher marks on the parameters 1 to 4 put together shall be placed above the other person in the merit panel.

A candidate has to get minimum 60% (60 mark and above out of total 100 mark) marks after interview for being included
in the merit panel. In case no candidate gets 60% marks, then the location will be re-advertised.

Page 8 of 16
 Annexure A

Standard Advertisement / Re- Advertisement Text

BHARAT PETROLEUM CORPORATION LTD

NOTICE FOR APPOINTMENT OF NON DOMESTIC LPG DISTRIBUTORS

BHARAT PETROLEUM CORPORATION LTD (BPCL) proposes to appoint Non Domestic LPG distributors at locations specified
below:

Sr.No State Location District Type of Market – Urban (U)/ Territory Address/ Contact No
Urban-Rural (UR) / Rural (R)
1.

For details on eligibility criteria and selection process please visit www.ebharatgas.com.

Page 9 of 16
 APPLICATION FOR BPCL NON DOMESTIC LPG DISTRIBUTOR

(FORM TO BE FILLED UP IN CAPITAL LETTERS USING BLUE/BLACK BALL POINT PEN)

For Office use D D - M M - Y Y
Not to be filled by Passport Size
applicant Office Code Serial No Date of receipt of application Photograph with
Particular of application fee Rs. specimen
Demand Draft signature on the
Date D D - M M - Y Y photograph
Number
Drawn on (Name of Payable
the bank) At
In favour of (Full name of the oil
company)
(Enclose Application processing fee of `1000/- (one thousand only) for all applicants except SC/ST candidate. Application processing fee for
SC/ST candidates is ` 500/- (Five hundred) on enclosing SC/ST certificate.

1 Name of the Location

2 District
3 State
4 Category OPEN

5 Advertised on D D - M M - Y Y Y Y
IN
(Please write Name of Newspaper)

6 Status of applicant: Individual Partnership (Tick as applicable )

7 Applicant should enclose Affidavit as per the format given in Appendix - 1
Name
7.1
First Name Middle Name Surname
Fathers /
7.2 Husbands
Name First Name Middle Name Surname

Address
7.3
Pin code :
Telephone No email:
Indian Citizen Yes No Resident of
7.4 if 'No' applicant is not eligible

Gender Revenue District

7.5
Male/ Female State

Date of Birth: Age Years Months Days

7.6 Attach Self Attested
D D - M M - Y Y Y Y Age as on date of application
Copy of Certificate
7.7 Marital Status Single / Married / Widow / Divorcee Strike off what is not applicable
Name of Spouse, If
7.8
married
Does any of the member (including yourself) of your "family Unit" is dealer/ YES NO
7.9 a Distributor or LOI holder of any MS – HSD/ SKO-LDO Dealership, LPG
Distributorship of any Oil Company. ‘if 'Yes' applicant is not eligible
i. In case of married person/ applicant, ‘Family Unit’ will consist of individual concerned, his/her Spouse and their unmarried son(s)/daughter(s).
ii. In case of unmarried person/ applicant, ‘Family Unit’ will consist of individual concerned, his/her parents and his/her unmarried brother(s) and
unmarried sister(s).iii. In case of divorcee, ‘Family Unit’ will consist of individual concerned, unmarried son(s)/unmarried daughter(s) whose custody is
given to him/her. iv. In case of widow/widower, ‘Family Unit’ will consist of individual concerned, unmarried son(s)/unmarried daughter(s).
YES NO
7.9 b Is any of your family member an employee of Oil marketing Company
‘if 'Yes' applicant is not eligible
Family member of an employee of Oil Marketing Companies means:
(i) The wife or husband as the case may be of the employee, whether residing with him / her or not, but does not include a wife or husband as the case may be
separated from the employee by a decree or order of a competent Court. Sons or daughters or step-sons or step-daughters of the employee and wholly
dependent on him, but does not include a child or step-child who is no longer in any way dependent on the employee or of whose custody the employee has
been deprived by or under any law.
(ii) Any other person related whether by blood or marriage to the employee or to such employee’s wife or husband and wholly dependent on such employee.

Name of the Location Page 1 of 7 (Signature of applicant)

Page 10 of 16
 8 I. Educational Qualification
Qualification University / Institution Degree Year of Passing
i) 10th Pass
ii) Graduate Degree
iii) Post Graduate
Professional
iv)
Degree

Note: Marks will be awarded based on the information given by the applicant on the education qualification. Self
attested copy of certificate to be attached. On verification if it is found that the information given above is incorrect/
false / misrepresented then the applicant's candidature will stand cancelled and will not be eligible

9 In case of partnership, please give name of each of the partners and attach Proposed Partnership
Deed. All partners should submit separate applications and Application of all the partner(s) should be
attached together while submission: (Please note each partner will have to submit separate application fee
and all the partners will have to appear for interview.)
Sr Percentage
No Name and Address Share

10 Experience

Do you have experience of running or working in any of the establishment dealing in the following for minimum
one year? Please give full details chronologically.
Number
Name and address of the Period
Type of Experience of
establishment/Institution etc
From To years
Direct Sale / Associated
with Industrial Gas,
Hotels
Other Petroleum
products, FMCG, other
retailing business.
Any other Trade

Note: Marks will be awarded based on the information given in the application and on answers to leading questions
in connection with experience claimed during interview. On verification if it is found that the information given is
incorrect/ false / misrepresented then the applicant's candidature will stand cancelled and will not eligible for
distributorship.

Name of the Location Page 2 of 7 (Signature of applicant)

Page 11 of 16
 11 Capability to provide infrastructure as on the date of application
11 GODOWN FOR STORAGE OF LPG CYLINDERS OF 2000 kg

Candidate should provide details of owned Godown / land for Godown on ownership or registered lease/ constructed godown / land for
Godown on offer basis for minimum period of 5 years at the time of submission of application. The LPG Godown should be of minimum
2000 Kg capacity located within 25 kms from municipal/ town/ village limits of location advertised.

Do you have a suitable land within 25 Km from municipal/town/village limits of the location offered in the same State for
LPG Godown or LPG Godown readily available. ( Godown land should meet the minimum dimensions of : 17m x 13m
Yes No
and meeting all the requirements of PESO for obtaining license capacity of 2000 KGs. For more details please refer to
PESO office / website: www.peso.gov.in)

Please strike off what is

Owned in your own name or in name of any member of your ‘Family Unit’.
not applicable

Note :The Own / registered lease deed for minimum 5 years of Godown/ land for construction of Godown includes ownership of the “Family Unit” /
parents (includes Step Father/ Step Mother), Grandparents (Both Maternal and Paternal), Brother/ Sister (Including Step Brother & Step sister), Son/
Daughter (including Step Son/ Step Daughter), Son in- law/ Daughter in –law of the applicant or the spouse (in the case of married applicant) as on
the last date of application as specified in the advertisement or corrigendum if any.

Note : Marks will be awarded to applicant either on ownership or offer for Owned LPG Godown/land for LPG Godown on ownership or registered lease/ Godown
on offer basis based on the information given by the applicant . On verification if it is found that the information given above is incorrect/ false/ misrepresented
then the applicant's candidature will stand cancelled and will not be eligible for distributorship.

If Yes to 11, Provide the following details and notarized affidavit as per Appendix – 2 if any

Date of Address of
registration the Distance
Relationship Khasra
Name(s) of the owner of LPG Godown / Land for of sale location of from
with No/Survey Dimensions of land *
godown deed/gift the land location
applicant No
deed /date for LPG in KM
of Mutation Godown

Length in Breadth
Meter in meter

12. Have you ever been convicted or charges have been framed by Court of Law for any criminal offence involving
moral turpitude and/or economic offence (other than freedom struggle)? (If yes you are not eligible to apply.) Yes / No
(Please strike off what is not applicable)

Name of the Location Page 3 of 7 (Signature of applicant)

Page 12 of 16
DECLARATION BY THE APPLICANT

I am aware that inter se suitability of candidates will be decided by evaluation of candidates on the document based
marks and interaction (interview). Evaluation on document based marks will be done based on the information given by
me/us in this application. On verification by the Oil Company if it is found that the information given by me/us is
incorrect/ false/ misrepresented then my/our candidature will stand cancelled and I/We will be declared ineligible for
LPG Distributorship. I also confirm that I am in possession of the supporting documents in original for the information
given by me in this application and if selected, failure to present these documents in original will result in cancellation
of selection due to submission of false/unsupported information in documents.

I am fully aware that if I am unable to make Godown duly approved by PESO on the land/godown indicated in the
application after selection then the allotment of distributorship made to me will automatically stand cancelled.

I have read the conditions for the distributorship mentioned in the advertisement and confirm that I fulfill the eligibility
criteria for the LPG distributorship I have applied in this application.

Name of the Location Page 4 of 7 (Signature of applicant)

Page 13 of 16
 UNDERTAKING

I, daughter of /son of/ wife of Shri. .

hereby confirm that the information given above is true and correct. Any wrong information /misrepresentation/ suppression of facts
will make me ineligible for this LPG distributorship.

Place : Signature of applicant

D D - M M - Y Y Y Y Name of applicant
Date :

Check list for Applicants (Check mark is compulsory)

S.No Document / Activity to be checked CHECK BOX YES/NO

1 DD attached - verify amount, drawn in favour of concerned Oil Company and

payable at ……………………._______________
2 Photograph pasted and signature across photograph

3 Notarized Affidavit in original as per format given in Appendix - 1 attached.

Notarized Affidavit in original as per Appendix -2 or Offer letter for godown land as
4 applicable

5 Undertaking in at the end of application duly signed with name, date and place
6 All pages of application are numbered and signed
7 Total Number of pages
8 The Application is complete in all respect

Name of the Location Page 5 of 7 ( Signature of applicant)

Page 14 of 16
 Appendix - 1

Notarised Affidavit

(TO BE TYPED ON APPROPRIATE NON JUDICIAL STAMP PAPER OF REQUIRED VALUE)

I, ______________________________________________son/ daughter/ wife of__________________________________________________

Age ______years residing at __________________________________________do hereby solemnly affirm and say as under

1 That I am an Indian Citizen and residing in India.

2 That my date of birth is D D / M M / Y Y Y Y (in words

That I passed 10th examination from recognized School / Institution in the year* / Y Y Y Y

and / or

3 That I have passed & completed the course of Graduate / Post-Graduate in the year* / Y Y Y Y

and /or

That I have passed & completed the Professional Degree in the year* / Y Y Y Y

That I am married and neither me or my Spouse and unmarried son(s)/daughter(s) have dealership/distributorship or hold Letter of Intent for Retail
Outlet or SKO-LDO dealership or LPG distributorship or RGGLV of any Oil Company. Or That I am married and my Spouse / unmarried
son(s)/daughter(s) do have dealership/distributorship or hold Letter of Intent for Retail Outlet or SKO-LDO dealership or LPG distributorship or RGGLV
of any Oil Company and I shall resign from te said distributorship before taking up this ND dstributorship if selected.

and /or
That I am un married and neither me or my parents and unmarried brother(s) and unmarried sister(s)have dealership/distributorship or hold Letter of
Intent for Retail Outlet or SKO-LDO dealership or LPG distributorship or RGGLV of any Oil Company. Or That I am unmarried and I/ my parents and
unmarried brother(s) and unmarried sister(s) do have dealership/distributorship or hold Letter of Intent for Retail Outlet or SKO-LDO dealership or LPG
distributorship or RGGLV of any Oil Company and shall resign from te said distributorship before taking up this ND dstributorship if selected.
4 and /or

That I am a divorcee and That I am a divorcee and neither me or my unmarried son(s)/daughter(s) have dealership/distributorship or hold Letter of
Intent for Retail Outlet or SKO-LDO dealership or LPG distributorship or RGGLV of any Oil Company. Or That I am a divorcee and I / my unmarried
son(s)/daughter(s) do have dealership/distributorship or hold Letter of Intent for Retail Outlet or SKO-LDO dealership or LPG distributorship or RGGLV
of any Oil Company and shall resign from te said distributorship before taking up this ND dstributorship if selected.dstributorship if selected.

and /or
That I am a widow/ widower and neither me or my unmarried son(s)/daughter(s) have dealership/distributorship or hold Letter of Intent for Retail Outlet
or SKO-LDO dealership or LPG distributorship or RGGLV of any Oil Company. Or That I am a widow/ widower and I / my unmarried
son(s)/daughter(s) do have dealership/distributorship or hold Letter of Intent for Retail Outlet or SKO-LDO dealership or LPG distributorship or RGGLV
of any Oil Company and shall resign from te said distributorship before taking up this ND dstributorship if selected.
5 That I am of sound mental health.

That I have never been convicted nor charges have ever been framed against me by any Court of Law for any criminal offences involving moral
6
turpitude and/or economic offences (other than freedom struggle).

That I hereby confirm that I was never a signatory to dealership/distributorship agreement of any Oil Company, which was terminated for proven
7
malpractices and / or for violations of provisions of the Marketing Discipline Guidelines.

That if any information/declaration given by me in my application or in any document submitted by me in support of application for the award of the Non
8 Domestic LPG Distributorship or in this affidavit shall be found to be untrue or incorrect or false, the Bharat Petroleum Corporation the distributorship (if
already appointed) and that I would have no claim, whatsoever, against the Corporation for such withdrawal / termination.

* Strike off whatever is not applicable.

I hereby verify that what has been stated above is true and correct to the best of my knowledge and nothing material has been
concealed there from.
Solemnly affirmed and declared before me. This day of

Signature and Seal of Signature of person making affidavit

Magistrate/Judge/Notary public (Name in block letters)

Name of the Location Page 6 of 7 (Signature of applicant)

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 Appendix – 2

Notarised Affidavit

(TO BE TYPED ON APPROPRIATE NON JUDICIAL STAMP PAPER OF REQUIRED VALUE)

Notarized Affidavit for offer of constructed LPG godown / land for construction of godown specified from member of the family unit/parents (includes
Step Father/ Step Mother), Grandparents (Both Maternal and Paternal), Brother/ Sister (Including Step Brother & Step sister), Son/ Daughter (including
Step Son/ Step Daughter), Son in- law/ Daughter in –law of the applicant or the spouse (in the case of married applicant)

All the joint owners of the constructed LPG godown / land for godown (except the applicant) have to submit this affidavit individually

I ___________________________________Son/ Daughter/ Wife of ___________________________________, age _________years and resident

of ________________________________________________________________ do hereby solemnly affirm and say as under:

1. That, I, Shri/Smt __________________________, own a constructed LPG godown / piece of land for construction of godown* jointly or jointly leased,
bearing Gatta/Khasra/Survey No. _________________ at ___________ (village/town), Taluka/Tehsil _____________________, Dist
____________, in the State of ____________ as per the following details.

Names of the Owner / Date of registration of Khasra No./Gatta Total Dimension of Dimension of Land Distance from the
Joint Owner(s) /Lessee Sale Deed/Gift No./Survey No. the plot of land ( offered as per municipal/ town/
/ Joint Lessee(s) Deed/Lease _____ metres x Demarcated Plan ( village limits of
Deed/Date of Mutation ______ metres) ______ metres x location advertised
_________ metres)

* Strike out whichever is not applicable

2. That Shri/Smt __________________ has applied for Non Domestic LPG distributorship of BPC at
________________________________(location) against the advertisement made in _________________________________(newspaper)
dated: _____________________________

3. That in case he/she is selected for Non Domestic LPG distributorship, I confirm that I do not have any objection for use of already constructed
LPG Godown/ land for construction of godown* specified in item no 11 and as detailed above in my name at the above mentioned location, as
per demarcation on the site plan enclosed, duly signed by all co-owners.

4. I hereby verify that what has been said above is true and correct to the best of my knowledge and nothing has been concealed therefrom.

Solemnly affirmed and declared before me

This_ day of

Signature and Seal of Signature of person making affidavit

Magistrate/Judge/Notary Public

Name of Deponent and Relationship

with applicant

Name of the Location Page 7 of 7 (Signature of applicant)

Page 16 of 16