SCHEDULE-VA (See rule 12(i) FORM-LM-1 APPLICATION FOR ISSUE OF LICENSES Application for license as manufacturer of weights, measures under Enforcement Act, 1985 To To be filled by the applicant Comments of the inspecting officer (1) (2) (3) 1 Name of the manufacturing concern for which licence is desired : 2 Complete address of the concern 3 Date of establishment of workshop/factory 4 Name(s) and address(es) of proprietor(s) and/or partners and Managing Director(s) in the case of Limited company: 5 The date and number of registration in the case of a Registered Factory : 6 Number and date of current Municipal Trade Licence : 7 Nature of Manufacturing activities at present: 8 The type of articles proposed to be manufactured, viz :i) Weights ii) Measures iii) Weighing instruments iv) Measuring instruments with details in each case : 9 The number of persons employed in each of the above branches of production : i) skilled ii) unskilled iii) specialists trained in the line 10 11 12 13 14 15 16 17 18 19 20 The monogram or trade mark intended to be Imprinted on articles to be manufactured: Details of machinery, tools, accessories, owned and used for manufacturing weights, measures etc.: Have you a foundry/workshop on ownership or long-term lease ? If not, state the nature and details of arrangements made or to be made in this regard: Indicate facilities for steel casting and hardness testing of vital parts : Is electric energy available ? Have you received any loan from government ? If so, give details : Name of bankers, if any : Sales Tax Registration Number : Give details of quota allotment of raw material for the last three years : Have you applied previously for licence ? If so, with what result ? When can you produce for inspection samples of your products for which licence is desired ? TO BE CERTIFIED BY THE APPLICANT Certified that I/we have read the Standards of Weights and Measures Rules, 1986 and agree to abide by the same and also the administrative orders and instructions issued or to be issued there under. I/We agree to deposit the schedules licnence fees with government as soon as required to do so by the licensing authority. All the information furnished above is true to the best of my/our knowledge. Place: Date: Signature and Designation
