I have this day taken from the premises of . situated at ..samples of seed specified below to have the same tested/analysed by Seed Analyst.
Date .. Seed Inspector .
Details of samples taken
cost of sample demanded ?
Cost of sample : Rs. paid
Seed Inspector .
Signature of the party from whose premises sample was taken and payment made.
( To be prepared in duplicate original copy to the seller and second copy with Inspector as office copy.)