FORM F. L./A-6-A

FORM F. L./A-6-A

[See rule 70A(1)]

Application No. ___________

Application for a tourist's permit to possess, consume, use and buy foreign liquor for personal consumption

1. Name in full (Surname first in BLOCK letters.) ___________
2. Permanent address ___________
3. Temporary address in the ²[State of Maharashtra]. ___________
4. Period of temporary stay in—
   1. The ²[State of Maharashtra]. ___________
   2. India. ___________
5. 1. Whether the applicant is a citizen of India. ___________
   2. Name of the country where the applicant—
      1. Was born ___________
      2. Was brought up ___________
   3. Name of the country in which the applicant is domiciled. ___________
6. Number and date of passport, and Tourist Introduction Card or Tourist's visa and the authority which issued it. ___________
7. Age. ___________
8. Number of units of foreign liquor per week. ___________

I hereby declare that—

• (a) I am a tourist.
• (b) I do not hold any permit under the Bombay Prohibition Act, 1949, for the possession, consumption, use and purchase of foreign liquor in the state of Maharashtra nor have I made any other application for such permit.
• (c) 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.

¹ Subs. by G. N. of 28-6-1956.
² Subs. by G. N. of 25-7-1963.

I request that L may be granted a tourist's permit for _____________________________ day

Date _______________________

To

The Collector of _________________________________________________________

The Prohibition and Excise _________________________________________________________________
Police Officer

*       *             *             *             *             *

[Reverse of Form F.L./A-6-A]

(For office use only)

Date of application __________________________________________

Registration No. __________________________________________________________

Permit prepared by ________________________________ and issued on ___________________________________

Received the permit No. __________________________________ on _____________________________________

Forwarded to the Superintendent of prohibition and Excise

_______________________

District Inspector of Prohibition and Excise, _________________________________

for disposal.

This is no certify that Excise _______________________________________________________
Police Officer

1 Deleted by G. N. of 8-7-1969.