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FORM RE 1 See rule 112 of the Explosives Rules 2008 Application for Renewal or revalidation of licence or certificate See also note below before filling up the form Form ----------------------------------------------------------------------------To Dear Sir I. on behalf of apply for renewal of licence or certificate number. in form. for the period from. to and furnish the following information During the last five 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. c Not issued any direction from the Court in connection with the above said licence or certificate. Give details if answer in affirmative ii Licence or certificate No. in Form. granted under the Act and these rules to me/us were cancelled/not renewed by the licensing authority. I/We also enclose the following documents approved plans and schedules. ii Renewal fee of Rs by bank draft of name of issuing bank bearing number date. payable in favour of I/We confirm that I/we shall inform you about the court s order or direction interim or otherwise if any issued in connection to the licence for which renewal is being applied failing which I/we shall commit a punishable offence. 4. I/We hereby certify that i. the above particulars given by me / us are correct. ii I am/we are aware that if explosives are illegally transferred by me/us to any unauthorised person s I/we shall commit a punishable offence. application I/we shall commit a punishable offence and in addition any administrative action can be taken against me/us. Signature of Licensee or certificate holder Authorised person in case of company Place Date application. Notes. 1 The complete renewal or revalidation application should reach the renewal authority before the expiry date of licence or certificate to avoid payment of late fees. on behalf of apply for renewal of licence or certificate number. in form. for the period from. to and furnish the following information During the last five 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. 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. c Not issued any direction from the Court in connection with the above said licence or certificate. c Not issued any direction from the Court in connection with the above said licence or certificate. Give details if answer in affirmative ii Licence or certificate No. in Form. granted under the Act and these rules to me/us were cancelled/not renewed by the licensing authority. Give details if answer in affirmative ii Licence or certificate No. in Form. granted under the Act and these rules to me/us were cancelled/not renewed by the licensing authority. I/We also enclose the following documents approved plans and schedules. ii Renewal fee of Rs by bank draft of name of issuing bank bearing number date.

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