EMBLEM FORM 'M' [See Clause 5] Form for Cash/Credit Memorandum to be issued by the Dealer/Manufacturer/[Importer]/ Pool Handling Agency to the Purchaser of Fertilisers ST/CST No. ......................... Date : .................................... Sl. No. .................................................... Certificate of Registration No. .............. Name and Address of Firm ................... Name and Address of Purchaser ......... Sl. Name of Fertiliser Number Batch Number Quantity Rate Amount No. and brand name of bags (wherever applicable) 12 3 4567 1. 2. X XX Total....... ST/CST @... G.Total..... Signature of Purchaser Signature of Dealer, etc.
