Form  of Application for license as a wholesaler/sub-wholesale dealer in kerosene.

1. Applicant's name & Address  :

2.  Applicant's place of business :

3.  How long the applicant has been trading in kerosene :

4.Quantity of Kerosene handled by the applicant

      during the past  one year                                       :

(Quantity to be specified  in metric Measure)

                                    I declare that the following quantities of kerosene for  sale are in my

                possession this day ,and are held at the  places noted against them  .

               Name of place   :

               Stocks              :

               Variety             :

              Quantity            :

                                    I   hereby certify that to the best of my knowledge the particular given

                   in this application  are true and correct.

                                                                                    (signature of the applicant.)