ࡱ > 7 9 6 bjbjupup 6 * * * * 6 4 * N j j j j j E E E ! # # # # # # $ G - E E E E E G j j t E " j j ! E ! j pHxc3 g " 0 ` d ` ` E E E E E E E G G E E E E E E E ` E E E E E E E E E : abc P H A R M A C Y A N D P O I S O N S A C T 1 9 3 3 a n d P O I S O N S A C T 1 9 7 2 A P P L I C A T I O N F O R R E G I S T R A T I O N T O S E L L N O N - M E D I C A L P O I S O N S U N D E R P A R T I I O F T H E P O I S O N S L I S T P l e a s e c o m p l e t e i n b l o c k c a p i t a l s N a m e o f p e r s o n r e s p o n s i b l e t o b e h o l d e r o f R e g i s t r a t i o n C o m p a n y N a m e (if applicable) Private Address/Company Address and Telephone Number Trade Business Address of Premises to be Registered Name of Deputy and/or Deputies permitted to sell Type of Non-Medical Poisons to be kept Any additional information Signature _____________________ Designation _____________________ Date _________________________ To be returned to the Licensing Office, North Ayrshire Council, Legal Services, 1st Floor, Cunninghame House, Irvine, KA12 8EE (Tel 01294 324305) e p ( . r m > h