Department of Labour Government of Tamil Nadu FORM LD-1 Application form for licence as Dealers in Weights and Measures under the Standards of Weights and Measures (Enforcement) Act, 1985 Sl. No. To be filled by the applicants Comments of the Inspection Officer. 1 2 3 1 Name of the Establishment / shop / person seeking the licence. : 2 a) complete address of the Establishment / shop / person b) whether premises are owned / rented / taken on lease / lease licence, duly supported by documents, : 3 Date of Establishment : 4 Name(s) and address (es) along with their father's / husband's name of proprietor(s) and / or Partners and / Managing Director(s) in the case of Limited company. : 5 Number and date or Registration Number of current shop / Establishment / Municipal Trade Licence. : 6 Categories of Weights and Measures sold / proposed to be sold at present. : 7 Registration Number of CST / Sales Tax / Professional Tax / Income Tax. : 8 Do you intend to import Weights, etc., from places, outside the State / Country? if so, indicate sources of supply (Give details of manufacture's trade mark / monogram and his licence number) : 9 Have you applied previously for a dealer's licence either in this state or elsewhere? if so, give details? : Certified that I/We have read the Standards of Weights and Measures Act 1976 the Standards of Weights and Measures (Enforcement Act, 1985 and the Tamil Nadu Standards of Weights and Measures (Enforcement) Rules1989 and agree to abide by the same and also the administrative orders and instructions issued or to be issued there under. I/We agree deposit the scheduled licence fees with Government as soon as required to do so by the Licensing Authority. All the information furnished above are true to the best of my / our knowledge. Date: Signature and Designation
