Department of Labour Government of Tamil Nadu SCHEDULE-VA (See Rule 12(1) FORM LM-1 Application form for licence as Manufacturer of Weights, Measures under the Standards of Weights and Measures (Enforcement) Act, 1985 Sl. No. To be filled by the applicants Comments of the Inspection Officer. 1 2 3 1 Name of the manufacturing concern for which licence is desired : 2 Complete address of the concern. Whether premises are owned / rented / taken on lease / lease licence, duly supported by documents. : 3 Date of establishment of workshop / factory. : 4 Name(s) and address(es) along with their father's / husband's name of proprietor(s) and / or Partners and / Managing Director(s) in the case of Limited company. : 5 The date and current Registration No.of Factory / Shop / Establishment / Municipal Trade Licence. : 6 Nature of manufacturing activities at present. : 7 The type of Weights and Measures proposed to be manufactured, viz - : i) Weights. ii) Measures. iii) Weighing Instruments iv) Measuring Instruments with details in each case : 8 The number of persons employed / proposed to be employed: i) Skilled: ii) Semi-skilled iii) Unskilled iv) Specialist in the line : 9 The monogram or trade mark intended to be imprinted on Weights and Measures to be manufactured. : 10 Details of machinery, tools accessories owned and used for manufacturing Weights and Measures, etc., : 11 Details of foundry / workshop facilities arranged. Whether ownership, long term lease, etc., : 12 Facilities of steel casting and hardness testing of vital parts. : 13 Availability of electric energy. : 14 Details of loan received from Government or financial institution. If so, give details. : 15 Name of Bankers, if any : 16 Sales Tax Registration No. / GST No. / Professional Tax Registration No. / I.T.No. : 17 Have you applied previously for a manufacturer licence. If so, when and with what results? : 18 a) Whether the item(s) proposed to be manufactured will be sold within the State (or) outside the State or both. b) Details of Modal Approval received from Government of India, or when can you produced for inspection samples of your products for which licence is desired? : To be certified by the applicant Certified that I/We have read, the Standards of Weights and Measures Act, 1976. The Standards of Weights and Measures (Enforcement) Act, 1985 and the Tamil Nadu Standards of Weights and Measures (Enforcement) Rules, 1989 and agree to abide by the same and also the administrative orders and instructions issued or to be issued thereunder. I/We agree to deposit the scheduled licence fees with Government as soon as required to do so by the Licensing Authority. All the information furnished above are true to the best of my / our knowledge. Date. Signature and Designation.
