Form :

To,

Dear Sir,

                 I/We hereby apply for renewal of licence No. __________ in form __________ for the period from __________to __________ and furnish the following information :

During the last two years—
(i) I was/we were—

(a)not convicted/convicted and sentenced for __________for following offences __________.
(b)not ordered/ordered to execute under Chapter VIII of Code of Criminal Procedure, 1973, a bond for keeping peace or for good behaviour.

(ii) Licence No __________in Form __________granted under Explosives Act to me/us were cancelled/not renewed by the licensing authority.

I/We also enclosed the following documents :

(i) Licence No __________in Form __________together with approved plans and schedules.
(ii) Renewal fee of Rs __________by Cash/P.O. No __________/Bank draft of _______on   __________Bank  __________Branch, drawn in favour of  __________

 

                                                                          Signature of Licensee ____________________
                                                                         (Authorised person in case of company)
Place __________                                                Date of application  _______________________

 

Note.—The complete renewal application should reach the renewal authority at least thirty days before the expiry date of licence, to avoid payment of late fees. The licence will expire if no renewal application is received on or before the expiry date.