S.I. No. 188/1982 - Poisons Regulations, 1982

Poison	Form to which sale is restricted
Aldicarb	Preparations for use in agriculture, horticulture or forestry.
Alpha-chloralose	Preparations intended for indoor use in the destruction of rats or mice and containing not more than four per cent., mass in mass, of alpha-chloralose; preparations intended for indoor use in the destruction of rats or mice and containing not more than 8.5 per cent., mass in mass, of alpha-chloralose, where the preparation is contained in a bag or sachet which is itself attached to the inside of a device in which the preparation is intended to be so used and the device contains not more than 3 grammes of the preparation.
Arsenic, compounds of, the following:—
Calcium arsenites	Agricultural, horticultural and forestal insecticides or fungicides.
Copper acetoarsenite	Agricultural, horticultural and forestal insecticides or fungicides.
Copper arsenates	Agricultural, horticultural and forestal insecticides or fungicides.
Copper arsenites	Agricultural, horticultural and forestal insecticides or fungicides.
Lead arsenates	Agricultural, horticultural and forestal insecticides or fungicides.
Barium carbonate	Preparations for the destruction of rats or mice.
Carbofuran	Preparations for use in agriculture, horticulture or forestry.
Cycloheximide	Preparations for use in forestry.
Dinitrocresols (DNOC); their compounds with a metal or a base	Preparations for use in agriculture, horticulture or forestry.
Dinoseb; its compounds with a metal or a base	Preparations for use in agriculture, horticulture or forestry.
Drazoxolon; its salts	Preparations for use in agriculture, horticulture or forestry.
Endosulfan	Preparations for use in agriculture, horticulture or forestry.
Endothal; its salts	Preparations for use in agriculture, horticulture or forestry.
Endrin	Preparations for use in agriculture, horticulture or forestry.
Fenaminosulf	Preparations for use in agriculture, horticulture or forestry.
Fenazaflor	Preparations for use in agriculture, horticulture or forestry.
Fentin, compounds of	Preparations for use in agriculture, horticulture or forestry.
Mercuric chloride	Agricultural, horticultural and forestal fungicides, seed and bulb dressings, insecticides.
Mercuric iodide	Agricultural, horticultural and forestal fungicides, seed and bulb dressings.
Mercury, organic compounds of	Agricultural, horticultural and forestal fungicides, seed and bulb dressings, solutions containing not more than five per cent., mass in volume, of phenyl mercuric acetate for use in swimming baths.
Metallic oxalates other than potassium quadroxalate	Photographic solutions or materials.
Methomyl	Preparations for use in agriculture, horticulture or forestry.
Nitrobenzene	Argicultural, horticultural and forestal insecticides.
Oxamyl	Preparations for use in agriculture, horticulture or forestry.
Paraquat, salts of	Preparations for use in agriculture, horticulture or forestry
Phosphorus compounds, the following:—	Preparations for use in agriculture, horticulture or forestry.
Azinphos-methyl
Chlorfenvinphos
Demephion
Demeton-S-methyl
Demeton-S-methyl sulphone
Dichlorvos
Dioxathion
Disulfoton
Fonofos
Mecarbam
Mephosfolan
Methidathion
Mevinphos
Omethoate
Oxydemeton-methyl
Parathion
Phenkapton
Phorate
Phosphamidon
Pirimiphos-ethyl
Sulfotep
Thiometon
Thionazin
Triazophos
Vamidothion
Zinc phosphide	Preparations for the destruction of rats or mice.

PART II Poisons which may be sold by persons licensed under article 14 only to persons engaged in the trade or business of agriculture, horticulture or forestry and for the purpose of that trade or business

Aldicarb

Arsenic, compounds of, the following:—

Calcium arsenites

Copper acetoarsenites

Copper arsenates

Copper arsenites

Lead arsenates

Carbofuran

Cycloheximide

Dinitrocresols (DNOC); their compounds with a metal or a base; except winter washes containing not more than the equivalent of five per cent. of dinitrocresols

Dinoseb; its compounds with a metal or a base

Drazoxolon; its salts

Endosulphan

Endothal; its salts

Endrin

Fenaminosulf

Fenazaflor

Fentin, compounds of

Mercuric chloride; mercuric iodide; organic compounds of mercury, except solutions containing not more than five per cent., mass in volume, of phenyl mercuric acetate for use in swimming baths

Methomyl

Oxamyl

Paraquat, salts of

Phosphorus compounds, the following:—

Azinphos-methyl

Chlorfenvinphos

Demephion

Demeton-S-methyl

Demeton-S-methyl sulphone

Dichlorvos

Dioxathion

Disulfoton

Fonofos

Mecarbam

Mephosfolan

Methidathion

Mevinphos

Omethoate

Oxydemeton-methyl

Parathion

Phenkapton

Phorate

Phosphamidon

Pirimiphos-ethyl

Sulfotep

Thiometon

Thionazin

Triazophos

Vamidothion

PART III Poisons the sale of which is subject to the special conditions set out in articles 15 (1) (d) and 18.

Antibiotics, the following; their salts; their esters; their derivatives; salts of their esters; salts of their derivatives:—

Bacitracin

Cephalosporins

Erythromycin

Neomycins

Penicillins

Spectinomycin

Spiramycin

Streptomycins

Tetracyclines

Tylosin

Virginiamycin

Article 8

FIFTH SCHEDULE

Form of entry to be made in the book to be kept in accordance with article 8.

Date of sale	Name and quantity of poison supplied	Purchaser's	Purchaser's	Purchaser's	Purpose for which stated to be required	Date of certificate (if any)	Name & address of person giving certificate (if any)	Signature of purchaser, or where a signed order is presented the words "signed order" with the appropriate reference number
Name	Address	Trade, business or occupation

Article 7 (3)

SIXTH SCHEDULE

Statement of particulars permitted to be shown on label as to proportion of poison in certain cases

Name of Poison	Particulars
Alkaloids	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Aconite, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Belladonna, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Calabar bean, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Coca, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Colchicum, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Ephedra, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Ergot, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Gelsemium, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Jaborandi, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Lobelia, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Pomegranate, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Quebracho, alkaloids of, other than the alkaloids of red quebracho	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Sabadilla, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Solanaceous alkaloids not otherwise set out in the First Schedule	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Stavesacre, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
Veratrum, alkaloids of	The proportion of any one alkaloid that the preparation would be calculated to contain on the assumption that all the alkaloids in the preparation were that alkaloid.
yohimba, alkaloids of
Arsenic, compounds of	The proportion of arsenic (As) that the preparation would be calculated to contain on the assumption that the compound or compounds of arsenic in the poison had been wholly converted into elemental arsenic.
Barium, salts of	The proportion of barium (Ba) that the preparation would be calculated to contain on the assumption that the salts of barium in the poison had been wholly converted into elemental barium.
Hydrogen cyanide; cyanides, other than ferrocyanides and ferricyanides	The proportion of hydrogen cyanide (HCN) that the preparation would be calculated to contain on the assumption that the cyanides in the poison had been wholly converted into hydrogen cyanide.
Lead, compounds of, with acids from fixed oils	The proportion of lead (Pb) that the preparation would be calculated to contain on the assumption that the compounds of lead in the poison had been wholly converted into elemental lead.
Nux Vomica	The proportion of strychnine contained in the preparation.
Phenols	The proportion of phenols (added together) contained in the preparation.
Compounds of phenols with a metal	The proportion of phenols (added together) that the preparation would be calculated to contain on the assumption that the compounds of phenols with a metal had been wholly converted into the corresponding phenols.

Article 7 (4) (a)

SEVENTH SCHEDULE

Cautionary Notices

Name of Poison	Cautionary notice to be shown on label
Potassium hydroxide, sodium hydroxide and products containing either of those substances	"Caution. This substance is caustic."
Aldicarb	"Caution. This substance is poisonous. The inhalation of its vapour, mist, spray or dust may have harmful consequences. It may also be dangerous to let it come into contact with the skin or clothing."
Carbofuran	"Caution. This substance is poisonous. The inhalation of its vapour, mist, spray or dust may have harmful consequences. It may also be dangerous to let it come into contact with the skin or clothing."
Cycloheximide	"Caution. This substance is poisonous. The inhalation of its vapour, mist, spray or dust may have harmful consequences. It may also be dangerous to let it come into contact with the skin or clothing."
Dinitrocresols (DNOC); their compounds with a metal or a base; except winter washes containing not more than the equivalent of five per cent. of dinitrocresols	"Caution. This substance is poisonous. The inhalation of its vapour, mist, spray or dust may have harmful consequences. It may also be dangerous to let it come into contact with the skin or clothing."
Drazoxolon; its salts
Endosulfan
Endothal; its salts
Endrin
Fenaminosulf
Fenazaflor
Fentin, compounds of
Fluoroacetamide
Methomyl
Organic compounds of mercury in aerosols
Oxamyl
Phosphorus compounds, the following:—
Azinphos-methyl
Chlorfenvinphos
Demephion
Demeton-S-methyl
Demeton-S-methyl sulphone
Dichlorvos
Dimefox
Dioxathion
Disulfoton
Ethion
Ethyl p-nitrophenyl phenyl-phosphonothionate
Fonofos
Mecarbam
Mephosfolan
Methidathion
Mevinphos
Omethoate
Oxydemeton-methyl
Parathion
Phenkapton
Phorate
Phosphamidon
Pirimiphos-ethyl
Sulfotep
Thiometon
Thionazin
Triazophos
Vamidothion
Fluoroacetic acid; its salts	"Caution. This substance is poisonous. Inhalation of the powder is dangerous. It is also dangerous to let the substance come into contact with the skin or clothing."
Bromomethane Chloropicrin	"Caution. Do not inhale vapour or allow contact with skin, eyes or clothing."
Preparations containing aluminium phosphide	"Caution. This preparation is poisonous and gives off a poisonous vapour on exposure to air. Do not swallow, inhale the vapour or allow contact with the skin."

Articles 7 (8) and 12 (2)

EIGHTH SCHEDULE

Poisons required to be specially labelled for transport

Aldicarb

Aluminium phosphide

Arsenic; its compounds

Barium, salts of (other than barium sulphate)

Bromomethane

Carbofuran

Chloropicrin

Cycloheximide

Dinitrocresols (DNOC) and their compounds with a metal or a base, when contained in preparations for use in agriculture, horticulture or forestry, except winter washes containing not more than the equivalent of five per cent. of dinitrocresols

Dinoseb, its compounds with a metal or a base, when contained in preparations for use in agriculture, horticulture or forestry

Drazoxolon; its salts

Endosulfan

Endothal; its salts

Endrin

Fenaminosulf

Fenazaflor

Fentin, compounds of

Fluoroacetic acid; its salts; fluoroacetamide

Hydrogen cyanide; metal cyanides, other than ferrocyanides and ferricyanides, except preparations containing less than the equivalent of 0.1 per cent., mass in mass, of hydrogen cyanide (HCN)

Methomyl

Nicotine; its salts; its quaternary compounds; except in solid preparations containing less than four per cent. of nicotine

Oxamyl

Paraquat, salts of

Phosphorus compounds, the following:—

Azinphos-methyl

Chlorfenvinphos

Demephion

Demeton-S-methyl

Demeton-S-methyl sulphone

Dichlorvos

Dioxathion

Disulfoton

Fonofos

Mecarbam

Mephosfolan

Methidathion

Mevinphos

Omethoate

Oxydemeton-methyl

Parathion

Phenkapton

Phorate

Phosphamidon

Pirimiphos-ethyl

Sulfotep

Thiometon

Thionazin

Triazophos

Vamidothion

Strychnine; its salts; its quaternary compounds

Thallium, salts of

Article 13

NINTH SCHEDULE

Poisons required to be coloured in certain cases

Aldicarb

Arsenic; its compounds

Drazoxolon; its salts

Fentin, compounds of

Fluoroacetic acid; its salts; fluoroacetamide

Methomyl

Phosphorus compounds, the following:—

Azinphos-methyl

Chlorfenvinphos

Demeton-S-methyl sulphone

Dichlorvos

Dioxathion

Disulfoton in solution

Mecarbam

Methidathion

Mevinphos

Omethoate

Oxydemeton-methyl

Phenkapton

Phorate in solution

Phosphamidon

Pirimiphos-ethyl

Thiometon

Thionazin

Vamidothion

Article 14 (2)

TENTH SCHEDULE

Form of application for a licence under article 14

PART A

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Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Application for a licence to sell certain poisons set out in Part II of the First Schedule to the Regulations

To the ........................ Health Board.	To the ........................ Health Board.
I^(1) ................................................	trading as^(2) ............................................................ ........	trading as^(2) ............................................................ ........
............................................................ ............................................................ ...................................	............................................................ ............................................................ ...................................	............................................................ ............................................................ ...................................
hereby apply for a licence in respect of the following premises namely	hereby apply for a licence in respect of the following premises namely	hereby apply for a licence in respect of the following premises namely
^(3) ............................................................ ............................................................ ..............................	^(3) ............................................................ ............................................................ ..............................	^(3) ............................................................ ............................................................ ..............................
I hereby nominate^(4) ............................................................ ............................................................ .	I hereby nominate^(4) ............................................................ ............................................................ .	I hereby nominate^(4) ............................................................ ............................................................ .
to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.	to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.	to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.
I hereby declare that I do not propose to sell any poison set out in Part III of the Fourth Schedule to the said Regulations.	I hereby declare that I do not propose to sell any poison set out in Part III of the Fourth Schedule to the said Regulations.	I hereby declare that I do not propose to sell any poison set out in Part III of the Fourth Schedule to the said Regulations.
	Signature of applicant	.........................................
	Date	.........................................

^(1)Here insert name of applicant.

^(2)Here insert the name or trading style of the business or enterprise.

^(3)Here insert address of premises in respect of which licence is sought. A separate application and licence are required in respect of each premises.

^(4)If so desired insert the name/s of proposed deputy/ies (not more than two).

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PART B

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Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Application for a licence to sell poisons set out in Part II of the First Schedule to the Regulations

To the ............................................ Health Board.	To the ............................................ Health Board.
I^(1) ................................................ trading as^(2) ............................................................ .....................	I^(1) ................................................ trading as^(2) ............................................................ .....................	I^(1) ................................................ trading as^(2) ............................................................ .....................
............................................................ ............................................................ .....................................	............................................................ ............................................................ .....................................	............................................................ ............................................................ .....................................
hereby apply for a licence in respect of the following premises namely	hereby apply for a licence in respect of the following premises namely	hereby apply for a licence in respect of the following premises namely
^(3) ............................................................ ............................................................ .................................	^(3) ............................................................ ............................................................ .................................	^(3) ............................................................ ............................................................ .................................
I hereby nominate^(4) ............................................................ ............................................................ ....	I hereby nominate^(4) ............................................................ ............................................................ ....	I hereby nominate^(4) ............................................................ ............................................................ ....
to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.	to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.	to act as my responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations.
I hereby declare that I propose to sell poisons set out in Part III of the Fourth Schedule to the said Regulations.	I hereby declare that I propose to sell poisons set out in Part III of the Fourth Schedule to the said Regulations.	I hereby declare that I propose to sell poisons set out in Part III of the Fourth Schedule to the said Regulations.
I hereby declare that I have made that the necessary arrangements with	I hereby declare that I have made that the necessary arrangements with	I hereby declare that I have made that the necessary arrangements with
^(5) ............................................................ ..................................... ,	^(5) ............................................................ ..................................... ,	being a registered
^(6) ............................................................ .................................... ,	^(6) ............................................................ .................................... ,	for the purpose of compliance
with article 15 (1) (d) (i) of the said Regulations.	with article 15 (1) (d) (i) of the said Regulations.	with article 15 (1) (d) (i) of the said Regulations.
	Signature of applicant	.........................................
	Date	.........................................
I.....................................................	of............................................................ ..........................	of............................................................ ..........................
being a registered^(6) ............................................................ ........................................., hereby	being a registered^(6) ............................................................ ........................................., hereby	being a registered^(6) ............................................................ ........................................., hereby
consent to have my name entered in a licence granted pursuant to this application to sell poisons set out in Part III of the Fourth Schedule to the said Regulations under my direction and control.	consent to have my name entered in a licence granted pursuant to this application to sell poisons set out in Part III of the Fourth Schedule to the said Regulations under my direction and control.	consent to have my name entered in a licence granted pursuant to this application to sell poisons set out in Part III of the Fourth Schedule to the said Regulations under my direction and control.
	Signed	..............................................
	Date	..............................................

^(1) Here insert name of applicant.

^(2) Here insert name or trading style of the business or enterprise.

^(3) Here insert address of the premises in respect of which the licence is sought. A separate application and licence are required in respect of each premises.

^(4) If so desired insert the name(s) of proposed deputy(ies) (not more than two).

^(5) Here insert name and address of person under whose direction and control the sale of poisons set out in Part III of the Fourth Schedule to the Regulations is to be effected.

^(6) Here insert the words "pharmaceutical chemist", "dispensing chemist and druggist", "druggist", "veterinary surgeon", as the case may be.

_______________

Article 14 (3)

ELEVENTH SCHEDULE

Form of licence under article 14

PART A

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Licence No.	............................
Reference	............................
..................... Health Board	..................... Health Board

Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Licence to sell certain poisons set out in Part II of the First Schedule to the Regulations

The ............................................................ ............................... Health Board hereby grants to ...................... a licence under article 14 of the Poisons Regulations, 1982, in respect of the following premises namely ................................

The following person(s) is/are hereby specified as responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations ............................................................ ............................................................ .

This licence shall, unless sooner cancelled or suspended, continue in force until the last day of ................ 19......

	Signed on behalf of the Health Board.
	............................................................ ........
Date ...........................................................

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PART B

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Licence No.	.........................
Reference	.........................
..................... Health Board	..................... Health Board

Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Licence to sell certain poisons set out in Part II of the First Schedule to the Regulations

The ............................................ Health Board hereby grants to .............................................

............ a licence under article 14 of the Poisons Regulations, 1982, in respect of the following premises namely ............................................................ .........................

The following person(s) is/are hereby specified as responsible deputy(ies) for the purpose of article 14 (6) of the said Regulations ............................................................ ............................................................ ..................

............................................................ ............................................................ ......................................

............................................................ ............................................................ ......................................

The following person namely ............................................................ ..................................................

....................................of............................................................ ........................................................,

being a registered ..............................., is hereby specified for the purpose of article 15 (1) (d) (i) of the said Regulations.

This licence shall, unless sooner cancelled or suspended, continue in force until the last day of ................ 19......

	Signed on behalf of the Health Board
	............................................................ .......
Date ..........................................................

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Article 8 (3)

FIFTEENTH SCHEDULE

Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Certificate stating results of tests, examination or analysis

This Certificate is issued by me, the undersigned, for the purpose of article 21 of the Poisons Regulations, 1982, being^(1) ............................................................ ............................................................ .......................

............................................................ ............................................................ .....................................

I hereby certify that I received on the .................. day of ..................... 19...................... from^(2)

..................... of ........................... a sample of^(3) ....................... for test, examination and analysis; which was undamaged, duly sealed and marked^(4) ............................................

I further certify that the said sample has been tested, examined and analysed by me or under my direction and that the results are as follows:—^(5)

Signature ....................................................	Date ..................................................
Address .....................................................
...................................................

^(1) Here insert official title of analyst.

^(2) Here insert the name of the sampling officer or agent who submitted the sample for analysis.

^(3) Here insert the name or description of the substance or product.

^(4) Here insert the distinguishing mark on the sample and the date of sampling shown thereon.

^(5) Here insert the relevant results as appropriate.

GIVEN under the Official Seal of the Minister for Health this 18th day of June, 1982.

MICHAEL WOODS,

Minister for Health.

The Minister for Agriculture hereby consents to the enforcement and execution by his officers of the provisions of these Regulations as respects poisons set out in Part II of the First Schedule.

GIVEN under the Official Seal of the Minister for Agriculture this 18th day of June, 1982.

BRIAN LENIHAN,

Minister for Agriculture.

EXPLANATORY NOTE.

These Regulations provide that the retail sale of certain poisons (i.e. those specified in Part I of the First Schedule) may only take place at a retail pharmacy being lawfully conducted under the Pharmacy Acts. The Regulations also provide that certain other poisons (i.e. those specified in Part II of the First Schedule) may be sold by retail outlets licensed for that purpose, as well as through pharmacies.

The Regulations impose certain restrictions and obligations in relation to labelling of poisons generally, and in the case of certain poisons specify requirements in regard to record-keeping, packaging, colouring, storage and transport.

The Regulations contain special restrictions in relation to the sale of strychnine and certain other substances which are used mainly for pest control.

Appropriate exemptions are provided for supply of preparations containing poisons to hospitals etc. and for professional use, or for the purpose of wholesale dealing, export, etc.

The Regulations are made under the Poisons Act, 1961 , and will replace a number of provisions contained in earlier enactments which will be repealed when the Regulations come into force.

FOURTEENTH SCHEDULE

Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

Certificate for the purchase of strychnine

I hereby certify that so far as I am aware............................................................ ...................................

of ............................................................ ............................................................ ....................................

is the owner or occupier of the land(s) situated at ............................................................ .....................

............................................................ ............................................................ .........................................

and that he is a responsible person of good character.

I also certify that notice in writing has been given of the laying of poison on the said land(s) as required by section 14 of the Protection of Animals (Amendment) Act, 1965 .

Office Stamp	Signature of Garda
of Garda Station	............................................................ .........
	Rank ............................................................
	Date ............................................................ .

Article 21

THIRTEENTH SCHEDULE

Form of entry to be made in the book to be kept in accordance with article 18

Date of sale	Particulars of product sold	Particulars of product sold	Particulars of product sold	Purpose for which required	Purchaser's name and address	Signature of purchaser or where a signed order is presented the words "signed order" with the appropriate reference number
Name of product	Form and strength	Quantity

Article 16

TWELFTH SCHEDULE

Certificate for the purchase of a poison required under article 8

_____________

Poisons Regulations, 1982 ( S.I. No. 188 of 1982 )

For the purposes of article 8 of the Poisons Regulations, 1982, I, the undersigned, being a householder occupying^(1) ............................................................ ............................................................ ......................................

............................................................ ............................................................ ......................................

hereby certify from my knowledge of^(2) ............................................................ .................................

of^(1) ............................................................ ............................................................ ................ that he is a person to whom^(3) ............................................................ .................................................... may properly be supplied.

I further certify that^(4) ............................................................ ............................................................ .

is the signature of the said^(2) ............................................................ ....................................................

	.......................................................
	Signature of householder giving certificate.
Date ...............................................

^(1) Insert full postal address.

^(2) Insert full name of intending purchaser.

^(3) Insert name of poison.

^(4) Intending purchaser to sign his name here.

(Endorsement required to be made by a member of the Garda Síochána when the householder giving the certificate is not known to the seller of the poison to be a responsible person of good character.)

I hereby certify, in so far as is known to the Gardaí of the district in which

• ............................................................ ........................................ .....................................................

resides, that he is a responsible person of good character.

Office Stamp	Signature of Garda .............................
of Garda Station	Rank ..................................................
	Date ...................................................
* Insert full name of householder giving the certificate.

Article 18