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FORM G - Renewal of Registration

This document is an application form for renewal of registration as a pharmacist under the Pharmacy Act of 1948 in Telangana State, India. It requests renewal of registration and provides instructions for submitting required documents, including a passport photo, original certificates, residential proof, and payment. It lists the documents needed, such as renewal passbook, registration certificate, degree certificates, identification, and postal stamps for packaging. The applicant declares the information is true and agrees to follow pharmacy council rules.

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Showry Reddy Bandla
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315 views2 pages

FORM G - Renewal of Registration

This document is an application form for renewal of registration as a pharmacist under the Pharmacy Act of 1948 in Telangana State, India. It requests renewal of registration and provides instructions for submitting required documents, including a passport photo, original certificates, residential proof, and payment. It lists the documents needed, such as renewal passbook, registration certificate, degree certificates, identification, and postal stamps for packaging. The applicant declares the information is true and agrees to follow pharmacy council rules.

Uploaded by

Showry Reddy Bandla
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form G Date:

(See Rule 77)


Form of Application for Renewal of Registration

To AFFIX PASSPORT
The Registrar, SIZE PHOTOGRAPH
Telangana State Pharmacy Council, WITH WHITE
Vengalrao Nagar, Hyderabad.
BACKGROUND
Sir,

I request that my name be registered as a pharmacist under the Pharmacy Act, 1948 and that I may be
furnished with a certificate of registration. Necessary particulars are given on the online application.
I enclose herewith for your perusal and return the certificates in original and their copies for record in
your office. I hereby declare that I have read carefully and understood the instructions on the website
and that all entries on the online application are true to the best of my knowledge and belief. I agree
that I will follow the rules of the Pharmacy Council which may be laid down for the guidance of the
registered pharmacists from time to time.
Yours faithfully,

(Signatures of Applicant)
Address:

Enclosed Checklist for Renewal of Registration who are due for Renewal validate date i.e.31st
December 2019 & above
1. Renewal Pass Book Original + 1 Xerox copy (Original should be surrendered at the time of
submission).
2. Original Registered Pharmacist Certificate Original + 1 Xerox Copy of front & Back (Original
Should be Surrendered at the time of submission.
3. Additional Qualification Certificate (B.Pharm/M.Pharm) if registered in A.P.Pharmacy Council
(Original Should be surrendered at the time of submission) Original + 1 Xerox Copy.
4. Matriculation, S.S.C or Equivalent Certificate Original + 1 Xerox Copy.
5. Intermediate Certificate Original + 1 Xerox Copy.
6. Diploma/Degree/M.Pharm/Pharm.D Certificate Original + 1 Xerox Copy.
7. Bonafide Certificate or Study Certificate Original + 1 Xerox Copy.
8. If Employed in any field (Drug License/College/Industry ID etc) + 1 Xerox Copy
9. Residential proof of any one (Election ID/ Aadhar Card/Bank Account of Nationalized Bank
/Passport/Driving License): Original + 1 Xerox copy.
10. Recent Passport Size Photograph not less than 2 weeks with White Background (Without Mask
& Scarf).
11. 1 Big Size Cover 14''x 10'' affixed with Rs.40/- Postal Stamps. (Self-addressed as in Residential
Proof).
12. 1 Big Size envelope affixed with Rs.40/- Postal Stamps.

(Signature of Applicant)
(Office Use Only)
All Original Certificates Verified (............................................................)
Non-refundable deposit form
(To be submitted along with application for Renewal of Registration of D Pharm/B
Pharm/M.Pharm/Pharm D)

To
The Registrar,
Telangana State Pharmacy Council,
Vengalrao Nagar, Hyderabad.

Sub: Payment of Non-refundable deposit for future renewal of my registration.

Ref: My Application for registration submitted today.

I pay an amount of Rs.300/- (Rupees Three Hundred only) and request you to please
treat this amount as Non-refundable deposit for Renewal fees in order to avoid difficulties
arising out of my inadvertent failure to pay the renewal fees every (5) years, in time.
I further request you that necessary part of the Annual interest occurred on my deposit
be adjusted towards my renewal fees every (5) years and remaining amount if any be utilized
by the Council.
If due to some reason this amount becomes inadequate to cover my renewal fees, I
shall be to glad to remit such additional amount as you may decide.
In the event of cancellation of my registration or abolishing of NRD scheme, this deposit
may be accepted as my donation to the Council.
I assure you that I will inform you my residential or professional address if there is any
change.

Thanking you sir.

Yours faithfully,

Signature & Date

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