This memorandum from a seed inspector to a seed analyst includes details of a seed sample being sent for analysis. It provides the serial number of the sample, date of sampling, name and address of the person whose seed stock was sampled, kind and variety of seed, lot number, treatment and labeling information, and nature and quantity of any preservative added. A copy of the memorandum and impression of the seal used on the sample packet are also being sent separately to the analyst.

1. FORM V
Memorandum to Seed Analyst
Serial number of memorandum
From
…………………………………
…………………………………
To
The Seed Analyst
…………………………………
…………………………………
The sample described below is sent herewith for analysis under clause (b)
of Sub-section (1) of Section 14 and/or clauses (b) and (c) of Sub-section (2) Section 15 of
the Seeds Act, 1966 :
1. Serial Number of the sample : …………………………………
2. Date of sampling : …………………………………
3. Other information :
a. Name and address of the person from whose seed stock(s) sample
was drawn :
………………………………………………..
………………………………………………..
b. Kind and variety of seed : ………………………………......
c. Lot No. : ……………………………………
d. Treatment & labelling information :………………………...........
……………………………………………………………......
e. Nature& quantity of preservative (if any added) : ……………..
………………………………………………………………..
A copy of this memo and specimen impression of the seal used to seal the packet of
samples is being sent separately by post/hand*

2. Seed Inspector ………………………
Area …………………………………
Date................................
* Strike out which ever is not applicable.
( To be prepared in quinplicate – original copy to the Analyst along with sample, second copy to the Analyst
along with specimen impression of the seal, third copy to the seller, fourth copy with Inspector along with file sample
and fifth copy with Inspector as office copy.)