FORM NO. 4
(See rule 55)

Official Seal of the Issuing Authority
S. No......................................................
F. No.....................................................
GOVERNMENT OF INDIA
MINISTRY OF FINANCE
(Department of Revenue)
Certificate of official approval of import
(The Narcotic Drugs and Psychotropic Substances Rules, 1985)
.................................................................................being the authority empowered to issue Import
(The Issuing Authority)
Certificate under the Narcotic Drugs and Psychotropic Substances Rules, 1985 hereby approves the importation into India of the consignments containing narcotic drugs or psychotropic substances as specified in the Schedule below by;
M/s..............................................................................................................................................
From M/s.......................................................................................................subject to the condition that the consignment containing such drugs or substances shall be imported before................... by................................to (airport/sea port) in India.
In approving the importation of the consignment containing the said drugs or substances specified........................................................ (Issuing Authority) is satisfied that it is required solely for medical and scientific purposes.
Address of the Issuing Authority Designation of the Issuing Authority
Schedule specifying the narcotic drugs or psychotropic substances contained in the consignment to be imported.
1. This document is for..............(The authority to whom and the purpose for which it is being sent to be indicated).
2. The certificate is not valid unless it bears the Official Seal of the Issuing Authority on the top right hand corner.
Official Seal of Issuing Authority
S. No. ..............................................
F. No. ...............................................