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?. grffe,rq|Eqlci :
Name of the Applicant
r. errigT/qTqia +-trqrqr :
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ComplcteAdresses of the premises
At which the pre-packingor import
to be takenplace.
i. 3rrtisflsrTqrd oqq{rqT tl-q :
Name(s)of the ccmmoditiesto be
Pre-Packed/lmported
,t. ;rrqft+fard qffiirilrtfilr/riqffirl
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Name(s)of the NominatedPerson/
, Partners/Directors/Propriter

tfiifr (Dare) :
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Si gnaturelDesi gnation/Seal
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SCHEDULE XIII
of l)irector/persons
Formatfor nomination by thc C--ompany
[RuIe 29]

Noticeis herebygiven thatShri/ Srnt./Ms ..

Director of the (ttattte of the
company)has beennominatedby the cornpanyby a Resolr-rtion passedat
t h e i rm e e t i n gh e l do n a f -. . . ...... to
be in chargeof, and to,
responsible the saidcompany for the conduct of the
businessof the said company or
establishment/branch/ unit theleof ariil authorizedto erercise ail sucli
po'vvers and take all suchstepsas may be necessary or expedientto prel'ent
the comnrissionby the saidcompanyany offenceundcrthe Legal Metrology
Act 2009.
A certifiedcopy of the said Resolutionis enclosed.

Place:... of
Managing Director/Secretary
D a t e : .... (nameof the company)

Note.- Strikeout the portionwhich is not applicable.

I acceptthe abovenominationin pursLlance (2) of
of sr.rb-section
Section49 of the Legal Metrology Act. 2009 and Rule 29 of the Lc-eal
N{etrology(General)Rules.20ll madethereunder.

Place: Directorof
Date: (nameof the company)
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