Form 1
(See Rule 13 (1))
APPLICATION FOR AUTHORIZATION FOR MANAGEMENT AND HANDLING OF E-WASTE
1. Name and Address of the Unit:
2. Contact Person with Designation:
3. Category of E-Waste (as per Schedule I):
4. Quantity of E-Waste Generated (Monthly/Annually):
5. Details of Waste Storage Facility:
6. Details of Disposal Methods (Recycling/Refurbishing):
7. Declaration: I hereby declare that the information provided is true and correct.
Date: __________
Signature: __________
Designation: __________