FORM No. N-IV/S

1511949 : Bom. XXV]	Bombay Prohibition Act, 1949
FORM  No. N-IV/S
[See rule 15(4)]
Return showing Neera drawn and supplied from the Neera Supply Centre
No. ............................................... at ................................................. in the Taluka of
...................................... in the District of .............................................................................
during the month of ............................. 19 .
NAME  OF  N-IV  LICENSEE ...................................................
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Quantity of Neera supplied to
Quantity of Neera drawn persons holding licence
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Total	ManufacturringQuantityQuantity of
Month No.	Retail Gur and other of NeeraNeera used
and 1* of trees 1 ml.	Sale Articles destroyedfor manufacture
year tapped	—————— —————— ————— of 	Gur and
1 ml. 1 ml. 1 ml. other Articles
——————
1 ml.
(1) (2) (3) (4) (5)
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Articles manufactured from Neera	Signature of the
—————————————————————————————	licensee or his
Rub Authorised
Gur Sugar	Sweets (Sugar syrup) Ser	vant
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Kg. g Kg. g Kg. g Kg. g
(6) (7)
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1 Delated by G. N. of 25-2-1970.