83[FORM 24-E

[See Rule 154-A]

Application for Grant or Renewal of a Loan Licence to Manufacture for sale Ayurvedic (including Siddha) or Unani Drugs

 

1. I/We* ……………………...........of+……………………........... hereby apply for the grant /renewal of loan licence to manufacture Ayurvedic (including Siddha)or Unani Drugs on the premises situated at……………………........... C/o** ………… ………

2. Names of drugs to be manufactured (with details). ……………………...........

3. The names, qualifications and experience of technical staff actually connected with the manufacture and testing of Ayurvedic (including Siddha) or Unani drugs in the manufacturing premises.

4. I/We enclose

(a) A true copy of a letter from me/us to the manufacturing concern whose manufacturing capacity is intended to be utilised by me/us.

(b) A true copy of a letter from the manufacturing concern that they agree to lend the services of their competent technical staff, equipment, and Premises for the manufacture of each item required by me/us and that they shall maintain the registers of raw materials and finished products separately in this behalf.

(c) Specimen of labels, cartons of the drugs proposed to be manufactured.

5. A fee of Rs……………………...........has been credited to Government under the head of account ……………………........... and the relevant Treasury Challan is enclosed herewith.

 

Date………………...........                Signature……………………...

(Applicant)

 

* Enter here the name of the Proprietor, partners or Managing Director as the case

+ Enter here the name of the applicant firm and the address of the principal place of business.

** Enter here the name and address of the manufacturing concern where the manufacture will be actually carried out and also the licence number under which the latter operates.