Schedule 1

FORM-A (See Section 8(1) APPLICATION FOR REGISTRATION UNDER THE ANDHRA PRADESH ANIMAL FEED (REGULATION OF MANUFACTURE, QUALITY CONTROL, SALE AND DISTRIBUTION) ACT, 2020. MANUFACTURING / TRADING LICENSE 1. Applicant’s Name: 2. Applicant’s Full Address, Telephone Nos. Fax, email: 3.Name of the Managing Director, Directors, Proprietors, Partners, Owners etc: 4. Whether the Applicant is: • Manufacturer • Dealer/ Distributor • Storage Agent (Tick mark the appropriate) 5. Description of the Animal feed which the applicant wishes to manufacture or process (as defined in the Act) S.No. Name of the item Category Quantity (MT/month) 6. Description of the Packing/labelling which the applicant wishes to use manufacture or process animal feed/s S.N.o. Name of the item Category Pack size/size Packing material used 7. Plan of the factory and list of equipment 8. Whether any power is used in the manufacture of Animal feed/mineral Mixture. if so, state the exact Horse Power of the machine used. 9. Total quantity and value of Animal feed/mineral mixture if any, manufactured during the previous year I/We hereby undertake to comply with the provisions of the Andhra Pradesh Animal feed (Regulation of Manufacture, Quality control, Sale and Distribution) Act, 2020 and the rules made there under and the conditions of the licence. I/We have forwarded a sum of Rs.____________ in respect of the license fee by way of Cheque/DD/online payment (details of payment may be furnished) Place: ________________ Date: _________________ (Signature(s) of the Applicant(s)) FORM-B (See Section 8(3) LICENSE UNDER THE ANDHRA PRADESH ANIMAL FEED (REGULATION OF MANUFACTURE, QUALITY CONTROL, SALE AND DISTRIBUTION) ACT, 2020 This license shall bedisplayed in a prominent and conspicuous place of business premises 1.Name and Address of License holder: 2.License Number: 3.Address of the Place of Business/Manufacturing facility: 4.License valid from _______ to _________ 5. Description of the Animal feed to manufacture or process(as defined in the Act) S.No. Name of the item Category Quantity (MT/month) 6.Description of the Packing/labelling to use to manufacture or process animal feed S.No. Name of the item Category Pack size/size Packing material used License is granted to manufacture or sell or distribute or exhibit the above animal feeds subject to the provisions of the LICENSE UNDER THE Andhra Pradesh Animal feed (Regulation of Manufacture, Quality control, Sale and Distribution) Act,2020: The License holder shall comply with all the directions and conform to the specifications issued by the Licensing Authority from time to time. Terms and Conditions of Licence:- 1. This license shall be displayed in a prominent and conspicuous place in a part of the business premises open to public. 2. The licensee shall comply with the provisions of the Andhra Pradesh Animal feed (Regulation of Manufacture, Quality control, Sale and Distribution) Act,2020 and the rules and orders made there under. 3. The license shall come into force immediately and be valid for a period of three years from the date on which it is granted, unless sooner cancelled or suspended. 4. The licensee shall, from time to time, report to the licensing authority any change in the premises of his business of manufacturing or Processing the feed. Place:________________ Date:_________________ (Licensing Authority) FORM-D PRINTED FORMAT ON PACKAGE (See Section 17(i) -(Packing, Marking & Labelling) Livestock, Poultry & Petanimal feed Type of Feed and label of animal to be fed: Date of Manufacture and Best Before Use: Name and Address of Manufacturer: License Number: Batch No: Net Weight: Nutrient composition Moisture, percent by mass, Max. Crude protein (N x 6.25), percent by mass, Min. Crude fat, percent by mass, Min. Crude fibre, percent by mass, Max. Acid insoluble ash, percent by mass, Max. 1. This feed does not contain urea or any other non-protein nitrogen compounds including ammonium salts for small ruminants, poultry and pet animal feed. 2. This feed does not contain harmful substances. FORM-E PRINTED FORMAT ON PACKAGE (See Section 17(ii) -(Packing, Marking & Labelling) Mineral Mixture: Type of mineral mixture and label of animal to be fed: Date of Manufacture and Best Before Use: Name and Address of Manufacturer: License Number: Batch No: Net Weight: Mineral element composition Moisture (%), Max. Calcium (%), Min. Phosphorus (%), Min. Magnesium (%), Min. Sulphur (%) Copper (%), Min. Zinc (%), Min. Manganese (%), Min. Iron (%), Min. Iodine (%), Min. Cobalt (%), Min. Fluorine (%), Max. Acid insoluble ash (%), Max. Lead (ppm), Max. Arsenic (ppm), Max. Total ash (%) Salt (%) Min. 1.This mineral mixture does not contain ingredients of animal origin such as meat & bone meal, calcinated bone meal, di-calcium phosphate of animal Origin etc., 2.This mineral mixture does not contain marble powder, dolomite powder, ferric oxide, cupric oxide, manganese dioxide, unprocessed rock phosphate, etc., FORM-T YEARLY RETURN (See Section 46) Stock position (MT) ParticularOpening stock Produc tion/ Purcha ses Sold/ distribution Closing stock Cattle feed Calf starter TMR /Silage Broiler Starter Feed Broiler Finisher Feed Chick Feed Layer Feed Mineral mixture Pet animal Feed Any other I hereby confirm that the above-mentioned information is factually correct. Place: _________ Date: ___________ (Signature of the License certificate holder)