Fom 6 See clause 20¢(5) APPLICATION FOR PROVISIONAL REGISTRATION OF SIOSTINULANTS Application Ne: 15816 to, ‘The Controller of Fertilizer AVIGNHAA SREE CROP SCIENCES Date: 31-03-2022 ame of manufacturer along with address of nit where it is lacatech AVIGNHAA SREE CROP SCIEENCES. li. Address ofthe Regjstered office ofthe compary:4-3-103 , Sitaramapuram , Hayathnagar , Rangareddy -501505 ,Rangareddi, Telangana Ti Location and full adress of storage / godown(s) 4-3-1083 ,Sitaramapuram , Hayathnagar , Rangareddy -501505, Rangaredai, Telangana iv. Name and address ofthe applicant along with his designation, contact number and email ID: AVIGNHAA SRE CROP SCIEENCES , Propritor , PAN and Adhaar number ofthe authorized person: data.EncryptedResponse.data.data0] fertilizer company part] Name of biostiulant indicate the category of biortimulant ae specified in sub-clause (2) of claves 200): Target vil Brand Name’ Protein & Amino vi: Incase cf importer, following additonal information shall be provided: a. County of erg: Inia Is bostimulent registered under county of origin (provide the copy: yes Whether the agronomic efficacy tals 2d toxicity tas are conducted inthe county of rigin: ne tn Technical details of product Amino Acid: 12 % Fulvic Acid : 3% Buffers & Stabilizers: 85% Total: 100% 2 Labele and oat detail: Attached ‘Quantity manufactured and sold during asthe yeas (attach sale document); 2019 Litre 45.2020 - Litre 70 2021 - Litre 2490 Vesication, | AVIGNHAA SRE CROP SCIEENCES do hereby eolemnly verify tat tothe bat of my knowledge and belie the statement given above is contect and complete | AVIGNHAA SRE CROP SCIEENCES clearly understand that the certcate of registiation is abe to be canceled if any information or data submitted with application is found incorrect er false at ay stage Signature ofthe apalicant