Manual
› THE BOMBAY FOREIGN LIQUOR RULES, 1953
› FORM F. L. /A-3
Application Form
FORM F. L. /A-3
See rule 67(1)
See rule 67(1)
What this form is for
FORM F. L. /A-3 is an application for an emergency permit to possess foreign liquor for medicinal use on emergent occasions. It is filed by an individual who wishes to keep a stock of such liquor at home for sudden medical needs, and it is addressed to the Collector of the district. The applicant declares the kind of liquor required, any existing stock, and whether the household already holds or has applied for another emergency permit. The form is prescribed under rule 67(1) of the Bombay Foreign Liquor Rules, 1953, framed under the Bombay Prohibition Act, 1949.
Form text (extracted)
7671949 : Bom. XXV] Bombay Prohibition Act, 1949 FORM F. L. /A-3 [See rule 67(1)] Application No. Application for a permit to possess foreign Liquor for medicinal use on emergent occasions 1.Name in full Shri/Smt./Kumari. . (Surname first in BLOCK letters) 2.Residential address in full. . 3.Nationality . . 4.Religion . . 5.Age . . 6.Occupation . . 7.Monthly Income . . 8.Kind of liquor required. . 9.Whether the applicant is head of household I declare that — (a)I usually keep * ......................................... for medicinal use. (b) Ihave at present got stock of * ................................................... as under : (Here state the stock) (c) Neither I nor member of my house hold holds any Emergency Permit nor have I or any member of my household has applied for any such permit. 1 [(cc)I have +/have not been convicted on (date) +/ at any time of an +/any offence punishable under sections +/any provisions of the Bombay Pro- hibition Act, 1949. There is a +/is no prosecution under sections +/any provisions of the said Act pending against me in the +/any Court in Maharashtra State.] (d)The particulars given above are correct. I hereby undertake to abide by the conditions of the permit and the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made thereunder. Signature of the Applicant. Dated To. The Collector of .................................................................................. District. *Here entername of liquor. +Strike out whatever not applicable. 1.Ins. by G. N. of 17.5.1955. 768 Bombay Prohibition Act, 1949 [1949 : Bom. XXV Form of Receipt S. No. Received from ‡ ‡ an application for an emergency permit for liquor. Dated Signature of the officer receiving the application. The applicant is requested to present personally this receipt, on ................................... ————— FORM F. L./A-3 (or Office use only) Received the application Action taken — Date Date of registration Called on Permit prepared on by Checked by Permit ready for delivery on Received Permit No. on Signature of the Applicant. Seen. Filed. Signature of the permit-issuing authority. Name and address in full to be filled by the applicant.
Original PDF (as scanned from printed manual)