Form XXVIII

(see Rule 118 H (1))

NOTICE OF CHANGE OF MANAGER / OCCUPIER

This Form is to be sent to the Inspector of Factories within 7 days of

the change:

1. Full Name and Address of the :

Factory

2. Licence Number :

3. Full Postal Address for :

communications relating to

the factory

4. Whether the change relates :

to the Manager or Occupier

5. Name of outgoing Manager / :

Occupier

6. Full Name and residential :

address of the new Manager /

Occupier

7. Date of appointment of new :

Manager / Occupier

Date: Signature of Manager / Signature of Occupier

Note: In case of any change in the Partners or Directors, a list of names

of Directors / Partners with their residential address shall be attached to

this notice.