This document is an acknowledgement form for an inspector taking seed samples from premises to be tested by a seed analyst. It records the date, location, details of samples taken, whether payment was made for the samples, and signatures of the inspector and party where samples were taken. The form is prepared in duplicate, with one copy given to the seller and the other kept by the inspector as an office record.

1. FORM VIII
Acknowledgement of having taken sample
To
………………………………………………
………………………………………………
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
…………………………………….
…………………………………….
…………………………………….
Whether cost of sample demanded ?
Cost of sample : Rs. ……………………… paid
Seed
Inspector…………………….
Date …………… Area
………………………………
Signature of the party from whose premises sample was taken and payment made.

2. ( To be prepared in duplicate – original copy to the seller and second copy with Inspector as office copy.)