FORM XI
FORM OF RECEIPT FOR THE SEIZED INSECTICIDES
[Rule 32]
Receipt for stock of insecticides seized under section 21(1)(d)
of the Insecticides Act, 1968

The stock of the insecticide detailed below has this day been seized by me under the provisions of section 21(1)(d) of the Insecticides Act, 1968, from the premises of ________________________ situated at __________________________.

Details of the insecticide seized are:

     a. _______________________________________________________

     b. _______________________________________________________

     c. _______________________________________________________

     d. _______________________________________________________

Date.________________                                                     Insecticide Inspector                                                                          

                                                                                                      Official stamp