FORM I [See rule 3 (3)] Form of application for licence to commence or carry of business as a dealer in dangerous machine under the Dangerous Machine (Regulation) act, 1983 (Central Act 35 of 1983). 1. Name of applicant: 2. Whether sloe proprietorship/partnership/public limited company/private limited company/Trust ( Attested copy of the deed attached) 3. Full address 4. Dangerous Machine(s) for which license is required (Give trade name with brief description each) 5. Do the machines conform to specified standards? --------------------------------------------------------------------------------------------------------- 6. Name of whether licenced under the If yes number and date of licence manufacturer Dangerous Machine (Regulation) and name of licensing authority Act, 1983 ------------------------------------------------------------------------------------------------------------------------------- Note:- Information under paras (5) or (6) above, subject to verification, will be considered adequate for grant of licence. 7. I/We hereby apply, for commencing or carrying on business as a dealer in dangerous machines. A licence fee of Rs._________________________ (Rupees _______________________________) has been deposited in Punjab Government Treasury____________________________vide challan No. __________________________dated ___________________(copy enclosed). 8. I/We declare that I/We will not deal in machines which do not conformto the standards specified under the Dangerous machines (Regulation) Act, 1983 and the rules made thereunder by the Governmet of Punjab. 9. I/we We will abide by all the provisions of the Dangerous Machines (Regulation) Act, 1983, and instructions issued by the authorities under this Act from time to time. 10. I/We will keep the record and supply the requisite information to the Controller/Inspectors or persons authorized by them, as and when required. 11. I/We declare that Sh.____________________________son of____________________________ partner/Managing director/Share holder of the _________________________________________ firm will correspond with the authorities on behalf of all the partners concerned with the above firm________________________. Signature of the applicant (Full name in capital letters) Date; Place: Seal of the Firm
