Government Of Maharashtra

DEPARTMENT OF AGRICULTURE
FORM III
LICENCE TO SELL, STOCK OR EXHIBIT FOR SALE OR DISTRIBUTE INSECTICIDES,
[See sub-rules (4) of rule 10]

1. Old License Number LAID24090097 Date Of Issue 23/04/2024

New License Number LCID0420240632AMV Date Of Issue 23/04/2024

License to sell, stock or exhibit for sale or distribute insecticide(s) in the premises situated at _____________HOUSE NO.159, MAIN ROAD,
SAWATA CHOUK, WARD NO.22, Warud (M Cl), Warud, Amravati, MAHARASHTRA, 444906.
_________________________________________________________________
(Complete address alongwith PIN Code) is granted to M/s (Name, Complete Address, e-mail etc.,)
________________________________________WARUD TALUKA SAHAKARI SHETKI KHAREDI VIKRI SAMITI, HOUSE NO. 159, MAIN ROAD,
SAWATA CHOUK, WARD NO.22, Warud (M Cl), Warud, Amravati, MAHARASHTRA, 444906.
__________________________________________________________________
Storage validity period upto dated-________________________________________________________________________

as specified particulars of insecticide/ here with in Statement – I

1. The insecticide(s) shall be sell, stock or exhibit for sale or distribute insecticide(s) under the direction and supervision of the following responsible
person/ expert staff -

Name of The Designation of

Office Address of The Responsible Address for Correspondence of The
Sr.No. Responsible Person / Responsible Person
Person / expert staff Responsible Person / expert staff
expert staff / expert staff

HOUSE NO.159, MAIN ROAD, SAWAT

Mr. DIPALI HOUSE NO.159, MAIN ROAD, SAWATA C
A CHOUK, WARD NO.22, Warud (M C
1 SUKHADEVRAO MANAGER HOUK, WARD NO.22, Warud (M Cl), Waru
l), Warud, Amravati, MAHARASHTRA, 4
BARASKAR d, Amravati, MAHARASHTRA, 444906.
44906.

2. The licence is subject to such conditions as may be specified in the rules for the time being in force under the Insecticides Act, 1968 as well as the
conditions on the certificate of registration and others as stated below ( overleaf).

Digitally Signed by
RAHUL SHIRIRAM SATPUTE
Date:4/23/2024 9:38:22 PM
Date:23/04/2024

Notified Authority &

District Superintending Agriculture Officer,
LCIM0120230181
 CONDITIONS

1. This licence shall be displayed in the prominent place in the premises for which the licence is being issued and shall be produced for inspection as
and when required by an Insecticide Inspector, licensing officer or any other officer authorised by the Government in this regard.

2. Any change in the name of the expert staff, named in the licence, shall forthwith be reported to the licensing officer.

3. The licensee shall scrupulously comply with each and every condition of registration of the insecticide (s), failing which the licence is liable to be
cancelled.

4. No insecticide shall be sold or exhibited for sale or distributed or issued for use in commercial pest control operations except in packages approved
by the Registration Committee from time to time.

5. If the licensee wants to manufacture / sell, stock or exhibit for sale or distribute / stock and use for commercial pest control operations, any additional
insecticide, he may apply to the licensing officer for addition in the licence for each such insecticide on payment of the prescribed fee.

6. For pest control operations an application for the renewal of the licence shall be made as laid down in sub-rule (3A) of rule 10 of the Insecticides
Rules, 1971.

7. The licensee shall comply with the provisions of the Insecticides Act, 1968, and the rules made there under for the time being in force.

8. The licence also authorizes the storage and stocking of insecticide(s) manufactured at the licensed premises, in the factory premises for sale by way
of wholesale dealing by the licensee.

9. The licensee shall maintain the record of ‘date expired insecticides’ separately in the format as per Appendix A.

10. The licensee shall maintain the record of sale /distribution of insecticides in the format as per Appendix B and shall submit monthly return to the
Licensing Officer.

11. The licensee shall maintain the stock register for technical and formulated products separately as per Appendix C1 and C2, respectively. (For
manufacturer only)

12. The licensee shall submit the monthly return for technical grade and formulated insecticides separately as per Appendix D1 and D2, respectively. (
For manufacturer only)

13. The licensee shall maintain a record of periodical medical examination of persons engaged in connection with insecticides as per Appendix E.

14. All the registers are to be kept under secured custody by the Licensee and shall be provided for scrutiny any time to the Insecticide Inspector,
Licensing Officer or any other officer authorised by the Central Government and / or the State Government.

15. Any other condition(s) as specified by the licensing officer.

16. This is system generated and digitally signed license issued against truthfulness of attested documents submitted by applicant and the undertaking
given regarding its truthfulness. If any of the information submitted for obtaining the license is found to be false/ misleading/ miss presented will be
liable for punishment under the provisions of existing laws and in that case, the license deemed to be cancelled.

Approval Authority Remarks

ok

Digitally Signed by
Date:23/04/2024 RAHUL SHIRIRAM SATPUTE
Date:4/23/2024 9:38:22 PM

Notified Authority &

District Superintending Agriculture Officer,
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 LICENCE TO SELL, STOCK OR EXHIBIT FOR SALE OR DISTRIBUTE INSECTICIDES,

STATEMENT-I

License No. : LCID0420240632AMV Date of Issue :23/04/2024

Particulars of Insecticides
Sr Composite Formula Certificates Registration Number Supplier Firm Date of Marketing Validity
No. (Technical Name with A.I. % and (CIB&RC) Name Inclusion Whatever applicable
Formulation Type)
CIR-133299/2016-IMIDACLOPRID (wg) SUNSHINE AGRI P Upto the validity of both part
1 IMIDACLOPRID 70% WG 30/05/2016
(365)-1047 VT LTD y's license

AZADIRACHTIN (NEEM CIR-132802/2016-Neem Seed Kernel B SUNSHINE AGRI P Upto the validity of both part
2 28/03/2016
PRODUCTS) 0.15 % EC ased EC(354)102 VT LTD y's license
CIR-133462/2016-Chlorpyriphos (EC)(3 SUNSHINE AGRI P Upto the validity of both part
3 CHLORPYRIPHOS 20% EC 30/05/2016
54)-636 VT LTD y's license

CIR-133459/2016 Imidacloprid (SL) (35 SUNSHINE AGRI P Upto the validity of both part
4 IMIDACLOPRID 17.8% SL 30/05/2016
4)1055 VT LTD y's license

CIR-133460/2016 - Hexaconazole (SC) SUNSHINE AGRI P Upto the validity of both part
5 HEXACONAZOLE 5% SC 30/05/2016
(354)-558 VT LTD y's license

SUNSHINE AGRI P Upto the validity of both part

6 FIPRONIL 5% SC CIR-162996-Fipronil (SC) (399) 2682 07/05/2019
VT LTD y's license

AZADIRACHTIN (NEEM CIR-13280/2016 Neem Seed Kernel Ba SUNSHINE AGRI P Upto the validity of both part
7 28/03/2016
PRODUCTS) 1 % EC sed EC (354)-345 VT LTD y's license
CIR-65949/2011-Triacontanol (EW) (31 SUNSHINE AGRI P Upto the validity of both part
8 TRICONTANOL 0.1% EW 30/04/2011
5) -580 VT LTD y's license

CIR-162998/2019-Pendimethalin (EC) SUNSHINE AGRI P Upto the validity of both part

9 PENDIMETHALIN 30% EC 07/05/2019
(399)1100 VT LTD y's license

Digitally Signed by
Date:23/04/2024 RAHUL SHIRIRAM SATPUTE
Date:4/23/2024 9:38:22 PM

Notified Authority &

District Superintending Agriculture Officer,
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 LICENCE TO SELL, STOCK OR EXHIBIT FOR SALE OR DISTRIBUTE INSECTICIDES,

STATEMENT-I

License No. : LCID0420240632AMV Date of Issue :23/04/2024

Particulars of Insecticides
Sr Composite Formula Certificates Registration Number Supplier Firm Date of Marketing Validity
No. (Technical Name with A.I. % and (CIB&RC) Name Inclusion Whatever applicable
Formulation Type)
CIR-133298/2016-TRICYCLAZOLE SUNSHINE AGRI Upto the validity of both p
10 TRICYCLAZOLE 75% WP 30/05/2016
(WP)(365)-247 PVT LTD arty's license

AZADIRACHTIN (NEEM PRODUCTS) 0.3 % CIR-132800/2016-Neem Kernel Bas SUNSHINE AGRI Upto the validity of both p
11 28/03/2016
EC ed EC (354)343 PVT LTD arty's license

CIR-133457/2016-Acephate(SP)(35 SUNSHINE AGRI Upto the validity of both p

12 ACEPHATE 75% SP 30/05/2016
4)-517 PVT LTD arty's license

AZADIRACHTIN (NEEM PRODUCTS) 0.03 CIR-132801/2016-Neem Oil Based - SUNSHINE AGRI Upto the validity of both p
13 28/03/2016
% (300 PPM) W/W MIN. EC (354)-29 PVT LTD arty's license
EMAMECTIN BENZOATE 5% SG (FI) & CIR-162997/2019- Emamectin Benz SUNSHINE AGRI Upto the validity of both p
14 07/05/2019
(FIM) oate (SG)(399)1259 PVT LTD arty's license

CIR-133458/2016-PROFENOPHOS SUNSHINE AGRI Upto the validity of both p

15 PROFENOPHOS 50% EC 30/05/2016
(EC)(354)-463 PVT LTD arty's license

AZADIRACHTIN (NEEM PRODUCTS) 5 % CIR-132803/2016 Neem Extract Co SUNSHINE AGRI Upto the validity of both p
16 28/03/2016
EC ncentrate (354) 344 PVT LTD arty's license

CIR-101620/2012-GIBBERELLIC A SUNSHINE AGRI Upto the validity of both p

17 GIBBERELLIC ACID 0.001% L 28/02/2012
cid (L)(325)-1 PVT LTD arty's license

Digitally Signed by
Date:23/04/2024 RAHUL SHIRIRAM SATPUTE
Date:4/23/2024 9:38:21 PM

Notified Authority &

District Superintending Agriculture Officer,
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