Application for cancellation of Registration Certificate of establishment

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....ment 1. Registration No: 2. Name and Address of Establishment :- 3. Name and Designation of employer :- 4. Full address to which communication relating to the establishment to be sent :- ....

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.... has been made.   I/we hereby certify that the establishment having registration no.______ dated ______kept free from storage of hazardous chemicals and substances. [Strikeout whichever if ....