Form I
Application for Registration of Insecticides
[See Rule 6]
1.(a) Name and address of the applicant:
(b) e-mail address:
(c) Permanent Account Number (PAN).:
(d) Category of Application:
2. Name of the Insecticide which applicant proposes to import or manufacture:
(a) Common name
(b) Chemical name (CAS and IUPAC name, if available)
(c) CAS Number
3. Purpose of Registration: [whether for use in the country or export only or both]
4. Nature of application:
(a) import or manufacture:
(b) registration under Sections 9(3)/9(3B)/9(4) of the Insecticides Act, 1968:
(c) name of registrant, if equivalence is claimed:
(d) specify applicable guidelines:
5. Address of the premises
(a) of manufacture:
(b) where imported insecticide shall be converted into preparation or repacked or stock:
6. In the case of import, please state
(a) Name and address of the manufacturer:
(b) Name, address and e-mail id of the authority which authorised manufacturing in the country of export:
(c) Name and address of the supplier duly authorised by the manufacturer (if applicable):
(d) Is the insecticide registered in the country
(i) of manufacture:
(ii) from where supplies are expected to be made:
(e) Registration number, manufacturing licence number, period of validity of certificate of registration and manufacturing licence in the country of manufacture:
7. In the case of manufacture, whether the insecticide is proposed to be manufactured or repacked:
8. In the case of formulation, the sources of supply of technical grade material and status of registration in India
9. Chemical Composition (on per cent basis):
(a) Name of active ingredient(s):
(b) Impurities (in case of technical grade insecticide)
(c) adjuvant (other ingredients, in case of formulation):
(d) Total:
10. Stability in storage:
(a) Shelf-life:
(provide data as per the protocol approved by the board)
(b) Shelf-life claim:
(provide shelf-life undertaking)
11. Toxicity of the insecticide to mammals, wild life, aquatic animal:
(provide toxicological data generated at a testing facility as per the guidelines of the Registration Committee)
12. Bio-efficacy data as per guidelines of Registration Committee on plant diseases, insects, weeds and other harmful animals against which it is intended to be used:
(provide data generated at testing facilities approved by the Registration Committee)
13. Specific instructions for storage and use including first-aid and precautionary measures, which are proposed for labeling:
(As per the Insecticide Rules and the guidelines of the Registration Committee)
14. (a) Two copies of proposed specification (including method of analysis for the quality of the insecticide in Bureau of Indian Standard format and its residues along with one soft copy)
(b) Analytical test report(s) of a sample of insecticide applied for registration from a testing facility as per guidelines of the Registration Committee
(provide complete details, graphs, spectra, calculations, etc.)
(c) Characterisation of active ingredient in case of technical grade insecticide (using Ultra Violet, Infra Red, Mass and Nuclear Magnetic Resonance spectra)
15. Seven copies of the proposed labels and leaflets (including all printed or graphic matter which will accompany the package containing the insecticide) as per the Insecticide Rules, 1971.
16. Manner of packing:
17. Particulars of the fee deposited:
Signature of the applicant with seal
Verification
I ..s/d/o ..do hereby solemnly verify that to the best of my knowledge and belief the information given in the application and the annexure and statements/accompanying it, is correct and complete. I clearly understand that the certificate of registration is liable to be cancelled if any information or data, submitted with the application is found incorrect or false at any stage or any condition of registration granted against this application is violated.
I further declare that I am making this application in my capacity as and that I am competent to make this application and verify it by virtue of ., an attested copy of which is enclosed herewith.
Place:
Date:
Signature with seal
Note. (1) The application form, including the verification portion and Supplementary Information, must be signed in case of an individual, by the individual himself or a person duly authorised by him; in case of Hindu Undivided Family, by the karta; in case of a partnership firm, by the managing partner; in case of a company, by a person duly authorised by the Board of Directors; and in any other case, by a person incharge of or responsible for the conduct of the business.
(2) One self-addressed stamped envelope and adequate number of stamped envelopes, depending on the states where manufacturing premises is/are located must be enclosed along with the application.
Form II
Application for
(1) Grant of Licence to Manufacture Insecticides
[See Sub-rule (1) of Rule 9]
Or
(2) Grant of Licence to Sell, Stock or Exhibit for Sale or Distribute Insecticides,
[See Sub-rule (I) of Rule 10]
Or
(3) Grant/Renewal of Licence to Stock and use of Insecticides Commercial Pest Control Operations
[See sub-rules (3-A) of Rule 10]
(Submit separate application for different licence)
Photo of applicant
To
The Licensing Authority,
.
1. Name, address and e-mail address of the applicant:
2. Whether the application is for
(a) Grant of licence to manufacture insecticide;
(b) Grant of licence to sell/stock/exhibit for sale/distribution of insecticides:
(c) Grant/renewal of licence for commercial pest control operations
3. Address of manufacturing premises (in case of licence to manufacture)
(i) Complete address of premises,
(ii) Name of insecticides and its registration number (enclose copy of certificate of registration of the insecticide duly certified by the applicant)
(iii) Validity of certificate of registration (as on certificate of registration)
4. Complete address (including name of the lane, PIN Code, etc.) of the premises, where the insecticide(s) shall be
(a) stored/stocked:
(b) sold or exhibited for sale or issued for use in case of commercial pest control operations:
(c) whether any of the above premises is situated in residential area (undertaking to be submitted):
(d) whether food articles are also stored in any of the above premises (undertaking to be submitted):
5.(a) Qualification of the applicant/ the technical personnel under employment of the applicant:
| Sl. No. |
Name and designation |
Qualification |
Experience |
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(b) Whether fulfill minimum qualification as per Insecticide rules.
6. Training (wherever applicable)
(a) Name of the training/course:
(b) Duration of training/ course:
(c) Certificate awarded, if any (Enclose supporting documents)
7. In case of manufacture, details of facilities for manufacture of the insecticide, including infrastructure and those mentioned in Chapter VIII of the Insecticides Rules, 1971, and the minimum infrastructure guidelines provided by the Registration Committee.
(Enclose complete details in a separate sheet duly signed by the applicant)
8. In case of application for commercial pest control operations,
(Enclose supporting documents)
(a) address of rgistered, zonal and branch offices:
(b) address of the premises for which the licence is applied for:
(c) whether approval of technical expertise obtained:
(d) if yes, state reference number of approval, its date and validity:
(e) name of restricted insecticides for which approved:
(f) name of the responsible technical person:
(g) whether any quantity of restricted insecticide in possession as on date of application:
(h) if yes, particulars and respective quantity of each in possession:
(i) details of safety equipment, antidotes and all other essential facilities:
9. In case of licence to sell/stock, etc. and for commercial pest control operations, name of the insecticide(s) and its/their manufacturer/importer which the applicant intends to deal in and status of the principal certificate(s) in the format give below (Please enclose principle certificate(s) as per format Appended):
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Particulars of Insecticide |
Name of the Manufacturer/Importer |
Number of certificate of registration |
Detailed principal certificate number/date of issue/validity |
| 1 |
2 |
3 |
4 |
5 |
10. Full particulars of licence(s), if issued in the name of the applicant by any other state in the area of their jurisdiction:
11. In case of renewal, please state licence number and date of grant:
12. Particulars of the application fee paid by the applicant:
13. Any other relevant information:
Signature of the applicant with seal
Declaration
(Strike out which is not applicable)
(a) I .s/d/o .do hereby solemnly verify that the information given in the application and the annexures and statements accompanying it is correct and complete to the best of my knowledge and belief and that nothing has been concealed. I clearly understand that this licence is liable to be cancelled, if any information, or part thereof, is found to be wrong, fake or false at any stage or any condition of licence is violated.
(b) I declare that we have adequate space and facilities to stock insecticides, so as to maintain their quality on shelf.
(c) I shall not supply insecticide(s) to any distributor or dealer or person who does not have adequate space and facilities to stock them so as to maintain their quality on shelf under every circumstances. (for application for licence to manufacture)
(d) I also declare that I shall not take possession of any stock without satisfying myself with the quality thereof.
(e) I undertake that we shall forthwith inform any change in the responsible technical person.
(f) I undertake that we shall forthwith inform any change in principle certificate to the licensing officer (not applicable for application for licence to manufacture).
(g) I further declare that I am making this application in my capacity as .. and that I am competent to make this application and verify it by virtue of .., an attested copy of which is enclosed herewith. I further declare that I shall abide by the conditions laid down in the licence and failure to do so shall render the licence liable to cancellation.
Place:
Date:
Signature of the applicant with seal
APPENDIX
Principal Certificate
(Enclose with application wherever applicable)
[See clause (i) of sub-rule (4-A) of Rule 10]
(On the Letterhead of the Manufacturer)
No. . Date:
1. We manufacture the following insecticide(s) as per the details given below:
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Name of the insecticide (Mention trade name, if any, in parenthesis) |
Address of the manufacturing premises |
Licence number |
Date of issue |
Valid upto |
Name and address of the licensing authority |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
2. We hereby authorise M/s (Name, complete address & email)
..to sell, stock or exhibit for sale or distribute following insecticides, manufactured by us, in wholesale or retail in the Taluka/District/State as detailed below:
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Common name of insecticide (Mention trade name, if any, in parenthesis) |
Registration number and date of issue and validity |
Manufacturing Licence number and date of issue, validity if any |
Name of Taluka and District & State |
| (1) |
(2) |
(3) |
(4) |
(5) |
3. The above mentioned dealer shall obtain the abovedetailed insecticides
(a) directly from us:
(b) from the following distributor(s):
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Name of distributor(s) |
Complete Address, Phone No. & e-mail of the distributor (s) |
Licence number and date w.r.t. distribution of above insecticides |
Date of validity of the licence |
Complete address of the premises, where the distributor is stocking insecticides |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
4. The Dealer to whom this principal certificate has been issued shall procure abovedetailed insecticides from the abovementioned distributor. In the event of procuring these insecticides from any other distributor, this certificate shall become null and void.
Before issuing this certificate, we certify that we have inspected and ensured that the abovementioned distributor/dealer have adequate space and facilities to stock safely above-detailed insecticides and to maintain their quality on shelf and have obtained an undertaking to the effect that the insecticide(s) shall be stocked accordingly to maintain their quality on shelf under every circumstances
5. This certificate has been issued to enable the distributor/dealer obtain licence to sell, stock or exhibit for sale or distribute the abovedetailed insecticides, including those for stocking and use for commercial pest control operations, and is valid up to .. .
6. In case of suspension/revocationd: (date of validity).
Date:
Place:
Signature with
company's seal
To,
Name and address of distributor/dealer.
Copy for information to:
(i) the licensing officer, .. .
(ii) M/s (the distributor and his address), if the insecticides are to be supplied through distributors)
Signature with company's seal
Form III
(On Letterhead of the Licensing Officer)
Licence to Manufacture Insecticides
[See sub-rule (3) of Rule 9]
or
Licence to Sell, Stock or Exhibit for sale or Distribute Insecticides,
[See sub-rules (4) of Rule 10]
or
Stock and use of Insecticides for Commercial Pest Control Operations
[See sub-rules (3-A) of Rule 10]
(Separate licence to be issued for manufacture/sale, stock etc./pest control operations)
1. Licence Number .
Licence to manufacture/sell, stock or exhibit for sale or distribute insecticide(s)/carrying out commercial pest control operations in the premises situated at
.
(Complete address along with PIN Code)
is granted to M/s (Name, Complete Address, e-mail, etc.,)
.
as specified hereunder
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Particulars of the insecticide |
Number of Certificate of Registration |
Date of grant of Licence |
Validity of Licence, wherever applicable |
| 1 |
2 |
3 |
4 |
5 |
2. The insecticide(s) shall be manufactured/sell, stock or exhibit for sale or distribute insecticide/commercial pest control operations under the direction and supervision of the following expert staff:
(a) For manufacture: Name(s) and designation of the expert staff (Insecticide wise, if any); and
(b) For sale/stock/pest control operations: Name and designation of the expert staff
3. The licence is subject to such conditions as may be specified in the rules for the time being in force under the Insecticides Act, 1968, as well as the conditions on the certificate of registration and others as stated below.
Signature of the Licensing Officer Seal
Conditions
1. This licence shall be displayed in the prominent place in the premises for which the licence is being issued and shall be produced for inspection as and when required by an Insecticide Inspector, licensing officer or any other officer authorised by the Government in this regard.
2. Any change in the name of the expert staff, named in the licence, shall forthwith be reported to the licensing officer.
3. The licensee shall scrupulously comply with each and every condition of registration of the insecticide(s), failing which the licence is liable to be cancelled.
4. No insecticide shall be sold or exhibited for sale or distributed or issued for use in commercial pest control operations except in packages approved by the Registration Committee from time to time.
5. If the licensee wants to manufacture/sell, stock or exhibit for sale or distribute/stock and use for commercial pest control operations, any additional insecticide, he may apply to the licensing officer for addition in the licence for each such insecticide on payment of the prescribed fee.
6. For pest control operations an application for the renewal of the licence shall be made as laid down in sub-rule (3-A) of Rule 10 of the Insecticides Rules, 1971.
7. The licensee shall comply with the provisions of the Insecticides Act, 1968, and the rules made there under for the time being in force.
8. The licence also authorises the storage and stocking of insecticide(s) manufactured at the licensed premises, in the factory premises for sale by way of wholesale dealing by the licensee.
9. The licensee shall maintain the record of date expired insecticides separately in the format as per Appendix A.
10. The licensee shall maintain the record of sale/distribution of insecticides in the format as per Appendix B and shall submit monthly return to the Licensing Officer.
11. The licensee shall maintain the stock register for technical and formulated products separately as per Appendix C-1 and C-2, respectively. (For manufacturer only)
12. The licensee shall submit the monthly return for technical grade and formulated insecticides separately as per Appendix D-1 and D-2, respectively. (For manufacturer only)
13. The licensee shall maintain a record of periodical medical examination of persons engaged in connection with insecticides as per Appendix E.
14. All the registers are to be kept under secured custody by the licensee and shall be provided for scrutiny any time to the Insecticide Inspector, Licensing Officer or any other officer authorised by the Central Government and/or the State Government.
15. Any other condition(s) as specified by the licensing officer.
Signature of the licensing officer
APPENDIX A
Register of Date Expired Pesticides
[See sub-rule (a) of Rule 10-A]
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Name of insecticide Technical with min purity/ formula-tion type and % active ingredient |
Batch number |
Date of manufac-ture |
Date of expiry |
Name of manufac-turer |
Stocks received from and the quantity received (give unit details) |
Invoice number and date vide which received |
Quan-tity sold (give unit details) |
Quan-tity balance (Give unit details) |
How was the balance quantity disposed of? |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
(10) |
(11) |
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Signature of the dealer with date and seal
Verified with the record and found that the above information is correct.
Place:
Date
Signature of the Insecticide Inspector(seal)
APPENDIX B
Register for Sale/Distribution of Insecticides (Technical and Formulation) (Including Insecticides used in Commercial Pest Control Operations) (Record to be Maintaimaintained Insecticide Wise)
[See sub-rule (2) of Rule 15]
Particulars of the insecticide:
Registration number:
Month and year:
| Sl. No. |
Date of receipt of the insecti-cide |
Name of the manufacturer from whom received |
Name of supplier/ distributor, if any, throughwhom received |
Batch number |
Date of manu-facture |
Date of expiry |
Invoice details, number, Date and quantity (metric tonnes) vide which supply received |
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| Quantity (metric tonnes) |
Bill num-ber (name and address to whom sold/ distri-buted) date and quan-tity sold/ distri-buted |
Remarks |
| Previous balance, if any |
Received |
Sold/Distributed |
Balance |
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Date:
Signature
Company's seal
Verified with the record and found that the above information is correct.
Signature with date and seal of the Insecticide Inspector
APPENDIX C-1
Stock Register of Technical Grade Insecticide (To be maintained Insecticide wise)
[See sub-rule (3) of Rule 15]
(Quantity in metric tonnes)
| Date |
Opening balance |
Quantity imported |
Quantity manufactured |
Total quantity (2+3+4) |
Quantity sold |
Quantity utilised for formulation |
Total quantity (6+7) |
Closing balance |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
APPENDIX C-2
Stock Register of Formulated Insecticide
(To be maintained insecticide-wise)
[See sub-rule (3) of Rule 15]
(Quantity in metric tonnes)
| Sl. No. |
Opening balance of techni-cal grade pesticide |
Technical grade insecti-cide imported/ purcha-sed diverted |
Total techni-cal grade column (2+3) |
Total techni-cal grade used for formula-tions |
Balance of techni-cal grade insecti-cides (4+5) |
Opening balance of formula-tions |
Quantity formu-lated/ impor-ted |
Total formu-lated quantity (7+8) |
Quan-tity sold |
Closing balance |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
(10) |
(11) |
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APPENDIX D-1
[See sub-rule (4) of Rule 15]
Monthly Return/Statement of Technical Grade Insecticides (Manufactured/Imported) for the period To
| Serial Number |
Name of the insecticide |
Batch number |
Date of expiry |
Details of total Quantity imported/ Manufactured (Metric Tonnes) |
Quantity utilised for formulations (Metric Tonnes) |
Quantity sold (Metric Tonnes) With Name, address and licence number of purchaser |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
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Verification
I do hereby verify that what is stated above is true to the best of my knowledge and belief based on information derived from the records. I further declare that I am competent to verify this statement in my capacity as (Designation). In case the information is found to be false, I shall be held responsible under relevant provisions of the Act/Rules.
Signature ..
Name .
Seal
APPENDIX D-2
[See sub-rule (4) of Rule 15]
Monthly Return/ Statement for formulated Insecticides (Manufactured/Imported)
For the period .. To .
| Serial Number |
Name of the Insecticide formulation |
Batch number |
Date of expiry |
Details of total Quantity of technical grade insecticide used for formulation (Metric Tonnes) |
Total formulated/imported Quantity (Metric Tonnes) |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
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Verification
I do hereby verify that what is stated above is true to the best of my knowledge and belief based on information derived from the records. I further declare that I am competent to verify this statement in my capacity as (Designation). In case the information is found to be false, I shall be held responsible under relevant provisions of the Act/Rules.
Signature ..
Name
Seal
APPENDIX E
Register of persons engaged in connection with Insecticides Record of Periodical Medical Examination for the Calendar Year 20 ., Quarter Ending ., 20 .
[See Rule 37]
Serial number:
I. General Information
Name: Age:
Father's/Husband's name:
Complete address:
Sex:Identification mark:
Date of appointment:
Occupation: (Please specify the nature of duty of the past and of the present)
Details of use Personnel Protective Equipments:
(a) Protective clothing/overalls:
(b) Helmet/hood/hat:
(c) Dust-proof goggles:
(d) Rubber gloves impermeable to liquids:
(e) Respiratory device(s):
(f) Boots:
II. Medical Examination:
Past History
| Illness |
Poisoning |
Allergy |
Exposure to pesticides (Compound) |
No. of years/seasons and days of exposure per year |
Remarks, if any |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
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Family History:
| Allergy |
Psychological disorders |
Hemorrhagic disorders |
| (1) |
(2) |
(3) |
| Marital Status |
Nos. of Children Health status of children & any birth defect, if any |
Any other health related complaint |
| (4) |
(5) |
(6) |
Personal History:
| Smoking |
Alcohol |
Other addiction |
| (1) |
(2) |
(3) |
| Marital Status |
Nos. of Children Health status of children & any birth defect, if any |
Any other health related complaint |
| (4) |
(5) |
(6) |
Observations:
| Medical examination |
Pre-employment examination |
End of 1st quarter i.e. after 3 |
After 2nd quarter after 6 months |
After 3rd quarter after 9 months |
End of year |
Remarks |
| 1 |
2 |
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5 |
6 |
7 |
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1. General Examination:
(a) Height
(b) Weight
(c) Pulse rate
(d) Blood pressure
(e) Respiration: rate , rhythm , type
(f) Anaemia/Pallor
(g) Oedema
(h) Jaundice
(i) Skin condition
(j) Temperature
(k) Fatigability
(l) Sweating
(m) Sleep
(n) Urination
2. Gastro Intestinal
(a) Nausea
(b) Vomiting
(c) Appetite
(d) Taste
(e) Pain in abdomen
(f) Bowel movement
(g) Liver
(h) Spleen
3. Cardio-respiratory
(a) Nasal discharge
(b) Wheeze
(c) Cough
(d) Expectoration
(e) Tightness of chest
(f) Dyspnoea
(g) Palpitation
(h) Heart
(i) Cyanosis
(j) Tachycardia/Bradycardia
4. Neuro-muscular
(a) Headache
(b) Dizziness
(c) Irritability
(d) Twitching
(e) Tremors
(f) Convulsions
(g) Paresthesia
(h) Hallucinations
(i) Unconsciousness
(j) Superficial reflexes
(k) Deep reflexes
(l) Coordination
5. Eye
(a) Pupil
(b) Lacrimation
(c) Double vision
(d) Blurred vision
6. Psychological
(a) Temperament
(b) Judgment
(c) Nervousness
7. Kidney
Kidney Condition
8. Investigation
(a) Complete Haemogram : (Hb, TRBC, TLC, DLC, Platelet, Reticulacytes count, ESR)
(b) Liver Function Tests: (Serum Bilirubin, SAP, SGOT, SGPT, Cholesterol, Total Protein and serum albumin)
(c) Kidney Function Tests: (Blood urea, Serum creatinine)
(d) Blood Sugar, HbA1C
(e) *Serum cholinesterase
(f) ** Blood residue estimation (In case of Organochlorine once in a year)
(g) Urine - routine & microscopic
(h) X-ray chest (PA View): Once every year
(i) Ultrasound whole abdomen: Once every year
* Serum cholinesterase level should be measured at six monthly intervals in case of organophosphorus/carbamatic group of insecticides.
** In organochlorine group of insecticides the blood residue estimation should be done once a year. General remarks of the doctor in the light of the above examination.
III. Diagnosis
IV. Advice Given To
1. The employee
2. The employer:
Signature of the Doctor with date and seal
V. Acknowledgement to be given by
1. The employee
2. The employer:
3. The Licensing Officer:
VI. Action taken by the employer on Doctor's advice:
VII. Certificate by the Doctor:
Certified that M/s . have completed the action as per my/doctor's advice as given above and consequently the patient has shown mprovement/recovered from the ailment.
Signature of the Doctor with date and seal
Form IV
Report of Insecticide Analyst
[See sub-rule (3) of Rule 24]
Sl. No.
Part A Coding Portion*
1. Name of the Insecticides Inspector from whom the sample has been received:
2. Serial number and date of Insecticides Inspector's Memorandum:
3. Particulars of the sample:
(a) Name of technical grade insecticide(s) purported to be contained in the sample along with nominal active ingredient content and type of preparation:
(b) Batch number:
(c) Date of manufacture:
(d) Date of expiry:
(e) Date of receipt of sample in the laboratory:
4. Number or mark of identification of the sample assigned by the Insecticide Inspector:
5. Packaging of the sample:
(a) whether securely packed, fastened: and sealed:
(b) whether the seal was on outer cover alone:
(c) whether the seal was on the sample alone:
(d) whether the seal was on both, outer cover and the sample:
(e) whether the seal was intact and unbroken:
(f) whether the seal on sample and outer cover
(as the case may be) tallied with the specimen seal:
(g) describe in general the packaging of the sample in the parcel:
(h) whether the sample was found fit for analysis:
6. The above detailed sample was given Laboratory Code Number:
Signature of the Coding Officer with seal
* To be filled and signed by a notified Insecticide Analyst (Laboratory In-charge) functioning as Coding Officer.
Part B Analysis Portion
7. Laboratory Code Number for sample:
| Sl. No. |
Test |
Requirement |
Result |
(a) Active ingredient(s):
(enclose chromatograms
spectra, if applicable)
(b) Other tests:
(i)
(ii)
(iii)
(iv).
8. Protocol(s) of the test(s) applied:
(a) For active ingredient(s):
(i) if published, Bureau of Indian Standards Number:
(ii) if not, method approved by the Registration Committee:
(b) For other tests:
9. Tests/analysis of the sample completed on (Date):
Remarks: 1. In view of the results of the test/analysis of the sample with respect to protocols thereof, the sample is declared as .
2. Photocopies of chromatograms/spectra (as applicable as per protocols of test applied) for standard and the sample are attached hereto.
Signature of the Insecticide Analyst Seal
Verification
I certify that I have analysed /caused to be analysed the aforementioned sample and declare the result of analysis to be as above.
Signed this .. day of ., 20 ..
Signature of the Insecticide Analyst Seal
Form V
Forms to be used by Insecticide Inspectors for Drawl of Samples, not to dispose of Stock, and Receipt of Seized Insecticides
V(A): Form of Order Not to dispose of any Stock
[See Rule 30]
Whereas, I have reason(s) to believe that the stock of following insecticides, which is in your possession, is being stocked, for distribution, sale or exhibited for sale and used in contravention of the provisions of section .. of Insecticides Act, 1968 and/or .of the Insecticides Rules, 1971
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Name of the insecticide with complete details |
Manufactured by |
Batch Number |
Date of manufacture and date of expiry |
Stock quantity as on date (indicate units also) |
Remarks |
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(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
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I hereby require you under clause (d) of sub-section (1) of Section 21 of the Insecticides Act, 1968 to stop the distribution, sales or exhibiting for sale and use of the said stock for a period of days from this day of .month of the year 20 .
Insecticide Inspector Seal
V(B): Form of receipt for the Seized Insecticides
[See Rule 32]
The stock of the insecticide(s) detailed below has this day of the month . of year 20 been seized by me under the provisions of clause (d) of sub-section (1) of Section 21 of the Insecticides Act, 1968, from the premises of M/s. .. situated at :
| Sl. No. |
Name of the insecticide with complete details, like purity, type of formulation, etc. |
Manufactured by |
Batch Number |
Date of manufacture and date of expiry |
Stock quantity as on date (indicate units also) |
Remarks (Mention page/folio number of the stock register) |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
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I have appended my signatures with date and seal on the page/folio number . of the stock register of insecticides and taken a copy thereof for record.
Date:
Insecticide Inspector Seal
V(C): Intimation to Person/Licensee from whom sample is taken
[See Rule 33]
To
M/s.
.
PIN :
I have this day of month year 20 taken from the premises of M/s (Sale/stock/distribution Licence number dated ) situated at , a samples of the insecticide specified below for the purposes of test or analysis:
1. Common name of the insecticide:
(mention complete details, like type of formulation)
2. Trade name, if any:
3. Manufactured by:
4. Registration number:
5. Marketed by:
6. Manufacturing Licence No.
7. Batch number:
8. Date of manufacture:
9. Date of expiry:
10. Stock before sampling:
(Mention units)
11. Quantity of the sample taken:
(Mention units)
12. Stock after sampling:
(Mention units)
13. Folio/page number of stock register:
14. Any other relevant information:
Date:
Insecticide Inspector Seal
1. Signature of witness: .
(Date, name and address)
2. Signature of witness: .
(Date, name and address)
Received one sealed portion of sample along with a copy of this Form.
Signature of the person from whom the sample is taken with date and seal
V(D): Form to be kept with sample in sealed packet
[See sub-rule (1) of Rule 34]
To
The Insecticide Analyst
1. Name of insecticide:
(Common name with active
ingredient % and formulation type)
2. Batch Number:
3. Date of manufacture:
4. Date of expiry:
5. Packing condition (original sealed/loose):
6. Quantity of the sample:
7. Sample drawn on:
8. Sample drawn by:
9. Specimen seal of insecticide inspector /
Licensee, if any:
10. Distinct mark on the sealed packet of sample:
Date:
Insecticide Inspector
(Signature and seal)
V(E): Memorandum to Insecticide Analyst
[See sub-rule (3) of Rule 34]
From
..
(Name, complete address and e-mail id of the Insecticide Inspector)
To
The Insecticide Analyst/In-charge of testing Laboratory,
..,
PIN:
1. The portion of sample/container described below is sent herewith for test or analysis under Rule 34 of the Insecticides Rules, 1971:
(a) Common name of the insecticide:
(nominal content, type of formulation, etc.)
(b) State of packing of the sample:
(c) Specimen Impression of the seal of the Inspector:
2. The portion of sample/container has been assigned the distinct number or marked by me with the following mark:
(Give number or the mark here)
3. A copy of this Memorandum along with a Form V(D) has been send separately with the sample by registered post or by hand (strikeout which is not applicable).
Place: New Delhi
Date: 20th April, 2018
Insecticide Inspector
Signature & Seal]
Schedule 2
(See Rule 25)
FEES FOR TESTING OR ANALYSING THE SAMPLES OF INSECTICIDES OR BIOPESTICIDE
1. Testing fees by following analytical techniques for samples of insecticides whose active ingredient is known.
| (I) |
Gas chromatograph |
Rs 6500/sample |
| (II) |
High performance liquid chromatograph |
Rs 7500/sample |
| (III) |
UV-visible Spectrophotometer |
Rs 5500/sample |
| (IV) |
Fourier Transform Infra Red Spectrometer |
Rs 6000/sample |
| (V) |
Titrimetric |
Rs 4000/sample |
2. Testing fees for sample of bio-pesticide whose active ingredient is known Rs 4000/sample.
3. Testing fees to test presence of registered bio-pesticide of below mentioned bio-origin from bio-product sample whose active ingredient is not known.
| (I) |
Nuclear Polyhedrosis Virus or Granulosis Virus only |
Rs 2000/sample |
| (II) |
Bacteria only |
Rs 2000/sample |
| (III) |
Fungi only |
Rs 2000/sample |
| (IV) |
For (I), (II) and (III) |
Rs 6000/sample |
4. Testing fees for analysis of samples of insecticide or bio-pesticides whose active ingredients is not known.
| (I) |
Liquid Chromatograph Mass Spectrometer |
Rs 15,500/sample |
| (II) |
Gas Chromatograph Mass Spectrometer |
Rs 10,500/sample |
5. The fees for test or analysis in respect of insecticide or bio-pesticide or any formulation other than the ones specified in this Schedule shall be specified by the Central Government or by any other officer authorised in this behalf from time to time.]
123[THIRD SCHEDULE
(see Rule 19)
PICTURE I: SAFETY PICTOGRAMS
.png)
124[PICTURE II: MODEL LABEL FOR ONE PANEL
(Applicable for 1 to 50 gm or ml and 51 to 250 gm or ml Primary package labels)
| Read leaflet before use (at least in English and Hindi) Common name: Brand Name Composition of the formulation or insecticides: Antidote: Diamond shape square-symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Name and Address of manufacturer: Imported and repacked by (wherever applicable): Registration No: Mfg Lic. No: Batch number: Mfg. Date: Expiry date: Net content: weight or volume (in metric system) MRP incl. of all taxes. Rs. Customer care details Similar content as above in Hindi |
PICTURE III: MODEL LABEL FOR ONE PANEL
(Applicable for 1 to 50 gm or ml and 51 to 250 gm or ml secondary package Label)
| Read Leaflet before Use (at least in English and Hindi): Common name: Brand Name Composition of the formulation or insecticides: Purpose: Re-entry: Crops and Pest Groups: Antidote Statement: Cautionary statements: Dosage, Direction for use and Manner and time of application: Please refer leaflet for details Safety Precautions, Symptom of Poisoning, First Aid: Please refer leaflet for details Diamond shape square-symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Name and Address of manufacturer: Marketed by: Imported and repacked by (wherever applicable): Registration No: Mfg. Lic. No: Batch Number: Mfg. Date: Expiry Date: MRP incl. of all taxes. Rs. Net Content: weight or volume (in metric system) Customer Care details: PICTOGRAMS Similar content as above in Hindi |
PICTURE IV: MODEL LABEL FOR ONE PANEL
(Applicable for >250 gm or ml primary and secondary package Label)
| Read Leaflet before Use (at least in English and Hindi): Common name: Brand Name Composition of the formulation or insecticides: Purpose: Re-entry: Crops and Pest Groups: Dosage, Direction for use and Manner and time of application: Please refer leaflet for details Safety Precautions: Symptom of Poisoning: First Aid: Antidote Statement: Cautionary statements: Diamond shape square-symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Name and Address of manufacturer: Marketed by: Imported and re-packed by (wherever applicable): Registration No: Mfg. Lic. No: Batch Number: Mfg. Date: Expiry Date: MRP incl. of all taxes. Rs. Net Content: weight or volume (in metric system) Customer Care details: PICTOGRAMS Similar content as above in Hindi |
PICTURE V: MODEL LABEL FOR TWO PANELS
(Applicable for 1 to 50 gm or ml and 51 to 250 gm or ml secondary package Label )
| Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Customer Care details: Registration No. Mfg. Lic. No. Batch No. Mfg. Date Expiry Date: MRP incl. of all taxes. Rs. Net content: weight or volume (in metric system) PICTOGRAMS |
Common name: Brand Name Composition of the formulation or insecticides: Purpose: Re-entry: Crops and Pest Groups: Dosage, Direction for use, and Manner and time of application: Please refer leaflet for details Diamond shape square-symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Safety Precautions, Symptoms of Poisoning andFirst Aid: Please refer leaflet for details Antidote: Cautionary statement: Name and address of Manufacturer: Marketed by: Imported & re-packed by (wherever applicable): Similar content as above in Hindi: |
PICTURE VI: MODEL LABEL FOR TWO PANELS
(Applicable for >250 gm or ml primary and secondary package Label)
| Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Customer Care details: Registration No. Mfg. Lic. No. Batch No. Mfg. Date Expiry Date: MRP incl. of all taxes. Rs. Net content: weight or volume (in metric system) PICTOGRAMS |
Common name: Brand Name Composition of the formulation or insecticides: Purpose: Re-entry: Crops and Pest Groups: Dosage, Direction for use, and Manner and time of application: Please refer leaflet for details Diamond shape square-symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Safety Precautions: Symptoms of Poisoning: First Aid: Antidote: Cautionary statement: Name and address of Manufacturer: Marketed by: Imported and re-packed by (wherever applicable): Similar content as above in Hindi: |
PICTURE VII: MODEL LABEL FOR THREE PANELS
(Applicable for > 250 gm or ml labels primary and secondary package and monocartons)
| Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Read Leaflet before use Customer Care details: PICTOGRAMS |
Common name: Brand Name Composition of the formulation or insecticides: Diamond shape square symbol, signal word and warning statements and any other information as per sub-rules (3), (4), (5), and (6) of Rule 19 Name and address of Manufacturer: Marketed by: Imported & re-packed by (wherever applicable): Registration No. Mfg. Lic. No. Batch No. Mfg. Date: Expiry Date: MRP incl. of all taxes. Rs Net content: weight or volume (in metric system) |
Purpose: Re-entry: Crops and Pest Groups: Dosage, Direction for use and Manner and time of application: Please refer leaflet for details Safety Precautions: Symptoms of Poisoning: First Aid: Antidote: Cautionary statement: Similar Content as above in Hindi] |