Application for registration for manufacture / distribution / sale / purchase / possession / storage / consumption of controlled substance in Schedule-A - See sub-clause (2) of clause 4 - Narcotic Drugs and Psychotropic Substances (Regulation of Controlled Substances) Order, 2013

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....nce and its salts in Schedule-A for which registration is applied for: 1) ____________________ 2) ____________________ 3) ____________________ 4) ____________________ 5) ____________________ (B) Purpose for which registration is applied for (Please put ✓ in appropriate box): (1) Manufacture                   (2) Distribution                   (3) Sale   (4) Purchase   (5) Possession   (6) Storage   (7) Consumption   (8) Others (Please specify)   Part-II (A) Name of the Applicant : (B) Complete postal address....

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....nbsp;                                                                                                                                                     &....

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....with PIN Code / Telephone / Fax Number (with city code) / e-mail ID} / copy of photo identity card issued by a Government Organisation / Election Commission / Details of conviction / pending cases under the Narcotic Drugs and Psychotropic Substances Act, 1985. (E) Complete postal address of business premises with PIN Code / Telephone / Fax Number (with city code) / e-mail ID:                                                                                            ....

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....;   (F) Complete postal address of Head Office with PIN Code / Telephone / Fax Number (with city code) / e-mail ID (if different from that given above):                                                                                                                                                  &nbs....

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.... Definite boundaries of the business premises (Description should correspond to the land revenue records) 1) North :_________________ 2) South : _________________ 3) East : _________________ 4) West : _________________ (H) Details of property holding rights of the applicant with respect to the business premises for which registration is applied for (Please put ✓ in appropriate box): Ownership            Lease / Rent                   If owned whether Mortgaged   Hypothecated   Please specify details of mortgage / hypothecation   (I) Name designation and address of the ....