| FORM A |
| ENTRY OF PREMISES |
| I/We (1) ........................................................................................................ |
| of (2) ............................................................................................................ |
| do hereby make entry of the premises occupied by me/us namely— |
| (3) ................................................................................................................ |
| ...................................................................................................................... |
| for the purpose of carrying on therein the trade or business of a |
| (4) ................................................................................................................ |
| and do hereby further make entry of the undermentioned |
| (5) ................................................................................................................ |
| ...................................................................................................................... |
| now in or upon the said premises to be used in connection with the said trade or business for the purpose hereinafter assigned thereto, respectively, that is to say— |
| (1) Name of firm or individual at full length. |
| (2) Street and number of premises (if any) |
| (3) The description and situation of the premises to be stated with sufficient fullness to ensure identification. |
| (4) Manufacturer of, &c. as the case may be. |
| (5) Rooms, places, vessels, utensils, as the case may be. |
| (6) Here describe the rooms, places, vessels or utensils intended to be used, the marks and numbers by which they are distinguished and the purpose for which used. |
| For example— |
| No. 1 marked “1” the laboratory facing the road. |
| No. 2 marked “2” the adjoining room for storing manufactured products. |
| No. 3 marked “3” the room to the left as you enter for the purpose of storing raw material. |