FORM IV FOREST RULES 1969 (RULES 15)

Disposal Permit For Forest Produce

Serial No.
FORM IV FOREST RULES, 1969 (RULE 15)
DISPOSAL PERMIT FOR FOREST PRODUCE
(PERMIT MENGELUARKAN KELUARAN HUTAN)
is hereby authorise to
(dengan ini telah dibenarkan untuk)
the following forest produce taken under Licence No.
(keluaran hutan berikut yang diambil di bawah No. Lesen)
in the name of
(atas nama)
issued at
(dikeluarkan di)
Permit expires on
(Permit ini tamat tempohnya pada)
Date Format: MM slash DD slash YYYY
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Place
(Tempat)
Date
(Tarikh)
Date Format: MM slash DD slash YYYY
Signature (Tandatangan)
Authorise Officer (Pegawai Berkuasa)