4. Schedule 5A [See rule 12 (1)] FORM LR-1 [Application for Licence as Repairers of Weights, Measures, Weighing Instruments and Measuring Instruments under the Standards of Weights and Measures (Enforcement) Act, 1985.] To SI Commodity To be filled in Comments of the No. by the applicants Inspecting Officers (1) (2) (3) (4) 1. Name of the repairing : concern/person seeking the licence 2. Complete address of the : workshop 3. Date of establishment : (1) (2) (3) (4) 4. Name (s) and address (es) : of proprietor (s) and/or partners, and Managing Directors (s) in the case of Limited Company 5. Number and date of : current Municipal Trade Licence 6. The types, of articles you : propose to repair 7. Area in which you wish : to operate 8. Extent of previous : experience in the line 9. The number of skilled : Staff employed in the workshop 10. Is electric energy available : 11. Have you sufficient stock : of loan/test weights, etc. Please give, details. 12. Have you previously : applied for repairer licence? If so, when and with what results To be certified by the applicants Certified that I/We have read the Standards of Weights and Measures (Enforcement) Act, 1985 and the Standards of Weights and Measures (Enforcement) Rules, 1988, and agree to abide by the same and the administrative and instructions issued or to be issued thereunder. I/We agree to deposit the scheduled licence fees and security deposit with Government as soon as required to do so by Licensing Authority. All the information furnished above is true to the best of my/our knowledge. Place : Date : Signature and Designation To be filled in by Department Officer of the State Government Date of receipt of application ................................................. Serial number of application ................................................... Date of Inspection ................................................................... Recommendation of Inspecting Officer: Final Orders of Licensing Authority Licence granted/refused. Licence No. Date: Valid till : Place : Date : Signature and Designation. 5.
