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Insecticides Rules, 1971

FORM XII

INTIMATION TO PERSON / LICENCEE FROM
WHOM SAMPLE IS TAKEN
[see rule 33]

To
_________________________________
_________________________________
_________________________________

I have this day taken from the premises of _____________________ situated at _________________ samples of the insecticide specified below for the purposes of test or analysis.

Date._________________ Insecticide Inspector

Details of sample taken._________________________________

Date.________________ Insecticide Inspector.

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