FORM II-A
GOVERNMENT OF INDIA
MINISTARY OF AGRICULTURE
(Department of Agriculture and Cooperation)
CERTIFICATE OF PROVISIONAL REGISTARION OF INSECTICIDES
[Rule 6]

Certified that the insecticide _____________________has been registered in the name of the person/ undertaking whose particulars are specified below provisionally for as period of two years effective from the date of issue:_____________________

     1.  Name of the person/ undertaking__________________________

     2.  Address ___________________________________________

     3.  Registration No.______________________________________

     4.  Name of the Insecticide________________________________

         (Brand name or trade name and chemical name or trade name and 
          chemical name of the insecticide, details composition)

     5.  Condition if any:

         (i)   ___________________________________________________

         (ii) ___________________________________________________

         (iii) ___________________________________________________

New Delhi, the _________20

Signature_____________
Seal of the Department_______________