Sample Form

(See rule 10)
To

(Name and address of the vendor)
…………………………………
…………………………………
…………………………………

Whereas  ……………………………………………….. intended for food which is in your possession appears to me to be adulterated/misbranded.

Now, therefore, under sub-section (4) of section 10 of the Prevention of Food Adulteration Act, 1954 (37 of 1954) I hereby direct you to keep in your safe custody the said sealed stock subject to such order as may be issued subsequently in relation thereto.

Place ……………….								
Date …………….							

Food Inspector
Area……………………