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Application Form 18012016 Latest

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78 views7 pages

Application Form 18012016 Latest

Application form
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
Extra No. 137 ahs aasudl 62 3400/- The Gujarat Government Gasette EXTRAORDINARY PUBLISHED BY AUTHORITY Vol. LVI TUESDAY, DECEMBER 8, 2015/AGRAHAYANA 17, 1937 Separate paging is given to this Part in order that it may be filed as a Separate Compilation. PART IV-A Rules and Orders (Other than those published in Parts I, I-A, and I-L) made by the Government of Gujarat under the Central Acts FOOD, CIVIL SUPPLIES AND CONSUMER AFFAIRS DEPARTMENT Notification Sachivalaya, Gandhinagar, 8" December, 2015. THE LEGAL METROLOGY ACT, 2009. No. GTH/2015/27/KMV/122014/732145/D :- WHEREAS, certain draft rules were published as required by sub-section (4) of section 53 of Legal Metrology Act, 2009(1 of 2010), at the separate pages 33- 1 in the Gujarat Government Gazette, Extraordinary, part IV-A, Dated the 31" March, 2011. Under the Government Notification Food, Civil Supplies and Consumer Affairs Department, No. GTH/2015/23/KMV/ 122014/732145/D dated 9" October, 2015, inviting objection or suggestion from all persons likely to be affected thereby within a period of thirty days from the date of publication of this notification in the Official ~ Gazene. AND WHEREAS, no objections or suggestions have been received from the public on the said draft rules; NOW, THEREFORE, In exercise of the powers conferred by sub section (1) of section 53 of the Legal Metrology Act, 2009 (1 of 2010) AND after consultation with Government of India, the Government of Gujarat hereby makes the following rules further to amend the Gujarat Legal’ Metrology (Enforcement) Rules, 2011, namely :- These rules may be called the Gujarat Legal Metrology (Enforcement) (Amendment) Rules, 2015. They extend to the whole of the State of Gujarat, They shall come into force from the date of publication of this notification in the Official Gazette. In the Gujarat Legal Metrology (Enforcement) Rules, 2011 (hereinafter referred to as 'the said rules’), in rule 11, in sub rule (2), for the word, figure and letter "Schedule II B, the word, figure and letter "Schedule II A" shall be substituted. 5. Inthe said rules, for SCHEDULE II A, the following shall be substituted, namely :- BRUNE IV-A Ex.-137 13%1 137-2 GUJARAT GOVERNMENT GAZETTE, EX., 8-12-2015 [PART IV-A SCHEDULE I A PHOTO (See rule 11(1)(2)) PHOTO FORM LM-1 / LM-2 Owner /Partner/ Person'who gave test Director/Chairman of WM manufacturing [Application form for new and renewal licence as manufacturer of weights and measures under the Legal Metrology Act, 2009) Mark (v’) wherever applicable 1. _ Name of the Manufacturing concern 2(a) Nature of the firm : individual (J Partnership [_]Company [—] Co-op. Soc. {] 2{b) Details of the individual making the application ‘Surname. Father/ Husband's Name... 20) 3fa) Y 3(b) Owned CI Rented [J 3(c)__ Firm commencement date : 3(d) Availability of electric energy : Connection No.: Whether Reg, Certificate Attached or not 4 Shop Act Reg. No. date: Yes No 5 5{a) Type of Weights and Measures to be manufactured (For new licence}/ manufacturing during last year Weights Measures Weighing Measuring instruments instruments 5(b) Whether details of above attached in Annexure-1/2 or not? ~ Yes No 6{a) No.of skilled persons employed 6{b) Whether details of above attached in Annexure-3 oF not ? yes LJ No 7. Whether model approval certificate attached or not ? (only for new licence) Yes No / 8. Whether details of machinery, tools, accessories attached in as per rule? Yes No 9. Did the applicant make any such application previously ? Yes No 10. Has the applicant been convicted for any offence / paid any compounding fee relating to L M Act/Rules inthe past? Yes No To be certified by the applicant(s) Certified that /We have read the Legal Metrology Act, 2009 and the Gujarat Legal Metrology (Enforcement) Rules, 2011 and agree to abide by the same and also the administrative orders and instructions issued or to be issued there under. All the information furnished above is true to the best of my / our knowledge. Place Date: . Name & Signature of Applicant 3 PART IV-A] GUJARAT GOVERNMENT GAZETTE, EX. 8-12-2015 137 Details of Owner / Partners / Directors / Members as applicable ‘Sr. ‘Name (Surname / = y No. Name / Father — — = = = Husband's Name) per > 5 3 é aS. 22/2 | # \|3 s oe 222 oe S wars ee 215 | 5 e |é = = [832 e"1k 12 3 6 2 18s € 8 g e 3 |e? \ zat ae 1 2 3 4 s 6 7 . 10 7 z 3 = si * Code for column No.8 41= illiterate. 36 = Agriculture 42= studied upto std. 7 37 = Business / Trading / 43 = SSC fail Profession 44 = Studied upto Std. 11 38 = Industry ISC pass 39 = Skilled worker 46 = Certificate Diploma after | 40 = Service in Govt. / Private Std, 10/12 organised sector 47 = Graduate / Post Graduate | 41 = Service in unorganised {Arts/Science/Commerce) sector (e.g. Smail private firm) .£./8.Tech / MBA/LLB/ LLM | 4: # Code for Column No.7 '$ Details of the applicant are top be provided at Sr. No. Details of Partners / Directors / Members are to be provided at Sr No.2 to Sr. No.8 as applicable. 4 Column No.5, and Column No.6 will apply to partnership firm / company / co-operative society Others ANNEXURE-1 (DETAILS OF WEIGHTS, MEASURES TO BE MANUFACTURED ) Sr.No. (1=weights, 2=measures, Code of Weights, Measures 3= weighing instruments, 4=measuring instruments) Type, Capacity and applicable Remarks of the Inspecting Officer class as 7 | | all ANNEXURE-2 (DETAILS OF Wi HTS, MEASURES MANUFACTURED DURING THE STOCK STATEMENT (only for renewal ) 12 MONTHS) [ Sr. No, ‘Opening Stock Quantity | Total(2+3) | Quantity sold | Closing stock (4-5) manufactured during the | during the month month _ ees! 7 2 3 4 5 6 | ANNEXURE-3 (DETAIL (LED EMPLOYEES) Sr.No. | Name Date of | Birth | Educational | Designation | Monthly | EPF | Remarks of joining | Date | Qualification Salary Rs. | No. | inspecting officer All the information furnished above is true to the best of my / our knowledge. Name and Signature of Applicant 137-4 GUJARAT GOVERNMENT GAZETTE, EX., 8-12-2015 [PART IV-A SCHEDULE A Pi — (see rule 13(3)(2)) Fue? FORM LD-1 / LD-2 Owner /Partner/ Manager/Administrator Director/Chairman application form for new and renewal license as Dealer of weights and measures under the Legal Metrology Act, 2009] Ble ce 2a) Nature of the firm : Individual [—] Partnership [] company [_]Co-op. Soc. foal 2b) Details of the individual making the application Surname.. NAME ern Father/ 5 Husband's Name 2c) Complete residential address of the applicant © OTN: Mobile No... 3{a) Complete address of the Office 3(b) Whether Office premises are: Owned [__] Rented E33 3(c) Firm commencement date: [————] 3(d) Availability of electric energy: ConnectionNo: = [1] 4 Shop Act Reg. No. Date Whether Reg.certificate attached or not Yes Oo No Oo 5(a) Type of Weights and Measures to be sold (For new license) Weights Measures Weighing Measuring instruments instruments 5(b) Type of Weights and Measures sold during the last 12 months (For renewal) Weights Measures Weighing Measuring instruments instruments ‘S{c)__ Whether details of above attached in Annexure-1/2 or not ? ves [] No 6(a) Whether the applicant intends to import weight / measure from other Country Yes{__]No | 6(b) _fyes, i)Name of manufacturer of other Country. ii)ticence No. of the manufacturer iiljimporter registration of weight, measure if applicable 7. Did the applicant make any such application previously ? Yes No 8. __ Has the applicant been convicted for any offence / paid any compounding fee relating to the LM Act / Rules in the past? Yes ~ OC To be certified by the applicant(s) Certified that I/We have read the Legal Metrology Act, 2009 and Rules and agree to abide by the same and also the administrative orders and instructions issued or to be issued thereunder. All the information furnished above is true to the best of my / our knowledge. Place: Date: Name and Signature of Avolicant PART IV-A] GUJARAT GOVERNMENT GAZETTE, EX. 8-12-2015 137-5 Details of Owner / Partners / Directors / Members as applicable E3 ‘Name (Surname / St a) No. Name / Father — E : 2s ea] . an | Husband's Name) ste g 3 2 i 3S | fee eit 2 1g | 2215 |= 2 |= 3 [835 S| ae 5 |g Selene a alee Pas 1 2 3a[ 4 5 6 3 10 fe | 5 = 5 | a See | alae ee] * Code for column No.8 # Code for Column No.7 $§ Details of the applicant are top | 41 = illiterate. 36 = Agriculture be provided at Sr. No. Details of 42 = studied upto std. 7 37 = Business / Trading /| Partners / Directors / Members | 43 = SSC fail Profession are to be provided at Sr No.2 to Sr. 44 = Studied upto Std. 11 8 = Industry No.8 as applicable. 45 = HSC pass 39 = Skilled worker A.Colunn No.5 and Column No.6 wil 46 = Certificate Diploma after | 40 = Service in Govt. / Private | apply to partnership firm / company std. 10/12 organised sector 1 co-operative society 47 = Graduate / Post Graduate | 41 = Service in unorganised | (Arts/Science/Commerce) sector (e.g. Small private firrn) 48 = 8.6,/8.Tech / MBA/LLB/LLM | 42 = Others ANNEXURE-1 (DETAILS OF WEIGHTS, Mi :S TO BE SOLD) (Only for new licence: Sr.No. | Code of Weights, Measures | Type, Capacity and class as | ~ Remarks | (1=weights, applicable = | | 2=measures, |= weighing instruments, yeasuring instruments) S ‘ANNEXURE-2 (DETAILS OF WEIGHTS, MEASURES SOLD DURING THE LAST 12 MONTHS) (Oni; renewal) STOCK STATEMENT Sr.No. ‘Opening Stock Quantity sold during the month for Closing stock (2-3) All the information furnished above is true to the best of my / our knowledge Name and Signature of Applicant 137-6 GUJARAT GOVERNMENT GAZETTE, EX., 8-12-2015 [PART IV-A (See rule 11(1)(2)) PHOTO FORM LR-1 / UR-2 PHOTO Owner /Partner/ Person who gave test Director/Chairman of WM Repairing [Application form for new and renewal of licence as repairer of weights and measures under the Legal Metrology Act, 2009] Mark (7) wherever applicable 1. Namie of the Repairing concern 2(a) Nature of the firm: Individual (—] Partnership - [—]_ Company (] Co-op.Soc. [7} 2(b) Details of the individual making the application Surname. vmumme Father? Husband's Nam 2{c) Complete residential address of the applicant : Tel No. 3(a)" Complete address of the workshop... Tel No.. Mobile No... 3{b) Whether workshop premises are : 3{c)__ Firm commencement date : 3{d) Availability of electric energy: Connection No. pe Whether Reg, certificate attached or not ‘Shop Act Reg. No. Date veep ey 5(a) Type of Weights and Measures to be repaired (new)/ repaired during the last year Weights Measures Weighing Measuring instruments instruments 5{b) Whether details of above attached in Annexure-1/2ornot? Yes wT] 6la) No.of skilled persons employed ....- 6{b) Whether details of above attached in Annexure-3 or not ? “es No 7. Whether details of machinery, tools, accessories attached in as per rule? yes No 8 Did the applicant make any such application previously ? Yes No [~] 9. Has the applicant been convicted for any offence / paid any compounding fee relating to LM Act/Rules in the past? Yes No To be certified by the applicant(s) Certified that /We have read the Legal Metrology Act, 2009 and the Gujarat Legal Metrology (Enforcement) Rules, 2011 and agree to abide by the same and also the administrative orders and instructions issued or to be issued thereunder. Al the information furnished above is true to the best of my / our knowledge. Place: Date: Name and Signature of the Applicant PART IV-A] GUJARAT GOVERNMENT GAZETTE, EX. 8-12-2015 137-7 Details of Proprietor / Pa ‘ors / Members as applicable Sano. Name = o (Surname | & s ‘s A ot iname/| 3 |e | 2 2.14 s As ratner- | SHS | 2 a|s 3 2 | Sas wusonds| 285 | 8 gié {3 3 52 name |g 3 e\¢ EB £ | i z a4 5 sop @ 3 [30 i 2 I 3 l 4 [ i * Code for column No.8 41 = illiterate. 42 = studied upto std. 7 43 = SSC fail 44 = Studied upto Std. 11 45 = HSC pass 46 = Certificate Diploma after ‘Std. 10/12 47 = Graduate / Post Graduate # Code for Column No.7 36 = Agriculture 37 = Business / Trading / Profession 38 = Industry 39 = Skilled Worker 40 = Service in Govt. / Private organised sector 41 Service in unorganised '$ Details of the applicant are top be provided at Sr. No. Details of Partners / Directors / Members are (tobe provided at Sr No.2 to Sr. No.8 as applicable. A Column No.5 and Column No.6 will apply to partnership firm / company / co-operative society 4=measuring instrument 3= weighing instruments, | ts) (Arts/Science/Commerce) sector (e.g. Small private firm) 48=B.E,/B.Tech / MBA/ LLB/ LLM ANNEXURI Mi REPAIRED) Sr.No. | Code of Weights, Measures | Type, Capacity and lass as | Remarks of the Inspecting (1=weights, applicable Os. 2=measures, ANNEXURE-2 (DETAILS OF WE! IGHTS, MEASURES REPAIRED DURING THE LAST 12 MON. ‘Details of user Details of weights 1S 2 | smeasuress | BE 5 Ess instruments ef ee 218 ee pe zg; /s al8 fe le |s2|s2| fay zbeel si Fsl2 8 Si/3 |8E|EEI SE; F822) 2) 82 = 2 as 8] 4 é|se~ Ss 3s > eee Se ir} | j i EI ees Ea ANNEXURE-3 (DETAILS OF SKILLED EMPLOYEES) Sr.No. | Name Date of | Birth | Educational | Designation | Monthly | EPF | Remarks of Joining | date | auaifeation Salary Rs. | No. | inspecting ae _| officer All the information furnished above is true to the best of my / our knowledge. Name and Signature of the Applicant

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