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Central Bureau of Narcotics
(Psychotropic Substance Control System)
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Application form for Registration of Other Institutions of Preparation(s) of Psychotropic Substances
1.Details of Institutions *(All Fields Marked * are Mandatory)
(i) Name of the Institution/Trader *
(ii) Address of Registered Office
Address Line 1*
Address Line 2
Address Line 3
Village/Town/City*
Pin Code*
State*
District*
(iii) Address of Corporate Office
Address Line 1*
Address Line 2
Address Line 3
Village/Town/City*
Pin Code*
State*
District*
(iv) Contact Details of Authorized Signatory *
NameDesignationTel No with STD CodeMobile No with Country CodeFax No with STD CodeEmailRemarks







       
Note : The verification mail and all communications will be send to the Primary Authorized Signatory
(v) PAN No.of the company/ Firm *
(vi) Website Address
2. Certification Details
(i) Company Incorporation Certification Details
(a) Certificate No.
(b) Date of Issue
(c) Issuing Authority
(ii) Details of IE Code by DGFT
(a) IE Code
(b) Date of Issue
Type the characters you see in the picture :
Characters* (Image Characters are Case Sensitive)