KARNATAKA STATE PHARMACY COUNCIL
514/E, I Main, II Stage, Vijayanagar, Bangalore – 560 104
Ph: +91-80-46729800 (800 to 899 lines), 080-23404000, 23383142
E-mail:
[email protected] Web_KSPC: www.kspcdic.com Web_KSPCDIRC - http://karnatakadruginfo.com/
RE-REGISTRATION APPLICATION
(TRANSFER) – KSPC-B
Application Form - Print the copy of the auto generated Application Form sent to your mail, sign (in BLACK ink
only) and send the original documents (mentioned in SL.No.3) to KSPC office through Post / Courier for verification
within 7 working days.
1. General Instructions
a. The applicant should be a Citizen of India and should have completed 18 years of age.
b. Registerable Qualifications - D. Pharm, B. Pharm, Pharm D approved by Pharmacy Council of India
c. Those who have already registered in other State Pharmacy Councils.
d. Renewal status in other state pharmacy council must be up-to-date.
e. Cancellation of Retail / hospital license (medical store/pharmacy) in your state.
2. Fees (Refer Notifications on www.kspcdic.com)
Payment – 1 (KSPC) Payment – 2 (KPCRPWT)* Payment – 3* (Additional
Registerable Qualification Qualification)
Amount: Rs.4,100/- (Rs.3,850/- & Amount: Rs.4,200/- (=<35 years) Amount: Rs.1,000/- per Qualification.
NOC request from other Amount: Rs.10,000/- (36 to 60 years) Account Name: “Karnataka State
Councils/States to KSPC of Pharmacy Council"
Rs.250/-) Account Name: “Karnataka Pharmacy Account Type: Savings Bank
Council Registered Pharmacist Welfare
Account Name: “Karnataka State Account No.: 52117060304
Trust "
Pharmacy Council" Bank Name: State Bank of India
Account Type: Savings Bank
Account Type: Savings Bank Branch: Vijayanagar II Stage
Account No.: 1052500100173701
Account No.: 52117060304 IFSC Code: SBIN0040231
Bank Name: Karnataka Bank Limited
Bank Name: State Bank of India
Branch: Vijayanagar
Branch: Vijayanagar II Stage
IFSC Code: KARB0000105
IFSC Code: SBIN0040231
Kerala State Pharmacy Council
DD in favor of “Kerala State Pharmacy Council, Thiruvanthapuram” Rs.500/-
Tamilnadu State Pharmacy Council
DD in favor of “The Registrar, Tamilnadu State Pharmacy Council, Rs.118/-
Chennai”
Maharashtra State Pharmacy Council
DD in favor of “Maharashtra State Pharmacy Council, Mumbai” Rs.590/-
3. Marks Card issued by competent authority - Scan (both sides wherever applicable) and keep ready the
following original documents before filling the Online application form
1. SSLC / 10th marks card
2. PUC - 1st & 2nd marks cards
Registrable Qualification – Qualified Pharmacist / D.Pharm / B.Pharm / Pharm.D
3. Diploma - 1st & 2nd Year marks card + Diploma Certificate
4. B.Pharm – 1st to 4th year marks card + B.Pharm Convocation Certificate
5. PharmD* – 1st to 5th year marks card + 6th year internship + PharmD Convocation Certificate
1
Additional Qualification
6. M.Pharm - 1st & 2nd Year + M.Pharm Convocation Certificate
7. Ph.D – Certificate
8. PharmD (PB) – 1st & 2nd year marks card + PharmD (PB) Convocation Certificate
Note: Provisional Degree Certificate (PDC) is valid for a period of one year from the date of issue of PDC.
4. Practical Training Form / Certificate to upload in original
✓ D.Pharm, B.Pharm & B.Pharm (Practice)
1. Appendix-E
2. Form 20, 21, 21C of the retail / medical /chemist shop of the registered pharmacist.
3. Registered Pharmacist Certificate of the master trainer.
4. Training undergone in Hospital - On a hospital letterhead with seal and signature you have undergone under a
Pharmacist and Director / Superintendent from the hospital and countersigned by the principal with seal, signature
and date.
Note:
1. Appendix – E - Section-I to V (All the sections must be filled, and the dates must be in chronological order only).
2. College Principal seal, signature, name of the principal with date.
3. Student signature with date.
4. Medical stores / hospital seal, signature, date and name of the registered pharmacist with Reg.No.
5. Any corrections made should be countersigned by the respective authority.
6. MERGE ALL THE DOCUMENTS AND UPLOAD UNDER TRAINNG CERTIFICATE
✓ B.Pharm - On a Company letterhead with seal and signature by the HR Manager/Head of the Industry and countersigned
by the principal with seal, signature and date.
✓ Pharm D / Pharm D (Post Baccalaureate) – Internship – Training in Hospital - For format refer
Sl.No.5(e) / click https://bit.ly/3KPSAKv
1. A certificate of satisfactory completion of training on a hospital letterhead with seal and signature from the
Director/ Superintendent of the hospital which shall be countersigned by the Principal or Dean of the Pharmacy College you
studied.
2. Logbook with attendance of each department with seal and signature of the HOD.
3. MERGE ALL THE DOCUMENTS AND UPLOAD UNDER TRAINNG CERTIFICATE
5. Other documents to upload
Sl.No. Particulars Details
a. Proof for Date of Birth (issued by SSLC or 10 marks card / Cumulative Record / Birth Certificate / Pan
th
competent authority) Card / Passport with validity
b. Address Proof of the Candidate (both Aadhar Card of Karnataka only issued by Government of India.
sides wherever applicable)
c. Aadhar Card (both sides wherever Upload Original Aadhar card of Karnataka only issued by Government
applicable) of India.
d. PCI approval letter (all the sheets) PCI approval letter for the year of admission (YOA) + previous year +
next year along with approved college list.
e. Student Study Certificate Letter from Click here to download the format of the certificate
College (original) https://bit.ly/3u7JMJa (College Principal seal, signature, registration
no, name of the principal with date and mobile number is
mandatory.)
f. Pharm D / Pharm D (Post Click here to download the format of Pharm D Internship Certificate
Baccalaureate) – Internship with logbook https://bit.ly/3KPSAKv
Certificate with logbook
g. Professional Status Letter for a Company / Institution / Hospital / Community Pharmacy
on a letter head that you are currently working with date of joining till
date + ID Card
2
h. Affidavit – Pharmacy Ethics (all the On Rs.100/- Non-Judicial Bond Paper (not less than 15 working days
sheets) on Karnataka Stamp Paper from the date of Notarization) attested by Notary as per format. Click
only here to download https://bit.ly/3N8CptU
i. Affidavit for Change of Name on Affidavit from 1st Class Judicial Magistrate / Court Order / Gazette
Karnataka Stamp Paper only Notification with Paper Advertisement on Rs.100/- Non-Judicial Bond
Paper with seal and signature authenticating change of name.
j. Registration Certificate & ID card / PP Original Registration Certificate & ID card / PP card / Pass book of
card / Passbook other State Pharmacy Council you last registered.
k. Photo Scan and upload the recent passport size colour photo which white
background only (jpg, jpeg). (Note: Profile photo will be rejected.)
l. Signature Sign, Scan and upload your signature in BLACK ink only on white
background. (jpg only).
KARNATAKA PHARMACY COUNCIL REGISTERED PHARMACIST WELFARE TRUST
(KPCRPWT-A)
‘Karnataka Pharmacy Council Registered Pharmacist Welfare Trust (KPCRPWT)’ is a social welfare scheme for
the benefit of the registered pharmacists and their families. It was established in the year 1998. For more
information refer https://kspcdic.com/krpwt
1. Eligibility:
➢ The applicant should be a Citizen of India and should been between 18 to 35 years of age to enroll under
KPCRPWT.
➢ The applicant must be a Registered Pharmacists in Karnataka State Pharmacy Council.
2. Benefits under this scheme:
➢ Medical Claim – Refer https://kspcdic.com/krpwt
➢ Death Claim - Refer https://kspcdic.com/krpwt
3. Uploads - Scan and keep ready all the following documents (Nominee should be blood relation only)
✓ Proof of Date of Birth of the Nominee - Birth Certificate / SSLC or 10th / Passport / Aadhar Card / PAN Card
✓ Address proof of the Nominee
✓ Aadhar Card of the Nominee
✓ Nominee Photo - Recent passport size colour photo which white background only (jpg, jpeg). (Note: Profile
photo will be rejected.)
✓ Nominee Signature - Sign and Scan your signature in BLACK ink only on white background. (jpg, jpeg).
ADDITIONAL DOCUMENTS IN CASE OF MINOR
✓ Self-attested address proof of the Guardian.
✓ Aadhar Card of the Guardian
✓ Guardian Photo - Recent passport size colour photo which white background only (jpg, jpeg). (Note: Profile
photo will be rejected.)
Guardian Signature - Sign and Scan your signature in BLACK ink only on white background. (jpg, jpeg).
Note:
1. Applications should be submitted by post / courier only.
2. Original Certificates submitted by the pharmacist will be returned along with the Council Certificates & Id card.
3. The Certificate issued by the Karnataka State Pharmacy Council will expire on 31 st December of the subsequent year of date
of registration.
4. Retention of Name in the register - Renew every year before 31st of March as per Sec.34 of the Pharmacy Act, 1948.
5. The council is nowhere responsible for any wrong information provided by the Candidate and deviations from the original
certificates. Please ensure proper filling of the application before submission.
Updated on 20-05-2024
