FORM No. 23

(Prescribed under Rule 12A)

Notice of Change of Manager

Name of Factory                                                        Registration Number

Post Address of factory                                             Licence Number

Town/Village, Pincode Number)

1.       (a) Name of the outgoing manager       :

          (b) Date of Relinquishing Charge of     :
              outgoing manager

2.       (a) Name of the new manager     :
          (b) Residential address              :

          (c) Telephone number               :

3.       Date of appointment of the new           :
manager

4.       Signature of the new manager    :

                                                          Signature of the occupier

                                                          Name (in block letters)

                                                          Address and Telephone Number