FORM 'J' [See Clause 28(1) (b)] FORM INDICATING PARTICULARS OF FERTILISERS SAMPLED (1) Name and address of dealer/manufacturer/Importer .............................. (2) Date of sampling ........................................................ (3) Details of markings on bags from where samples has been taken ........................................................................ (i) Type and grade of fertiliser with brand ................................ (ii) Name of manufacturer/Importer ........................................ (iii) Registration No. ............................................................ (iv) Lot No. and date of manufacture/import ............................ (v) Composition ....................................................................... (5) Serial No./Code No. of sample ................................................... (6) Stock position of the lot ............................................................. (7) Physical condition of fertiliser .................................................... (8) Whether samples drawn from open bags of stitched bags ................................................................................................... (9) Name & Address of Fertiliser Inspector drawing sample .......................... ....................................................................... (4) Date of receipt of the stock by the dealer/manufacturer/importer/pool handling agency ............................................................................. Signature & Metallic Seal Impression of Fert. Inspector. RECEIPT OF THE DEALER Certified that the sample of fertiliser has been drawn in accordance with the procedure laid down in the Fertiliser (Control) Order, 1985 from the stock in my possession, and I have signed the test samples at the time of wax sealing. I have also received one test sample out of the three test samples prepared. Signature of dealer/ Signature & Seal of manufacturer/Importer/Pool Fertiliser Inspector handling agency with address.
