FORM XIX Receipt for stock of insecticides seized under section 21(1)(d) of the Insecticides Act, 1968. The stock of the insecticides 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 insecticides seized are : 1__________________________________________________________
Date: ______________ Insecticides Inspector
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