FORM D

Bombay Prohibition Act, 1949 [1949 : Bom. XXV 1 [ FORM ‘D’ (See rule 5) Form of application for a licence to sell 6 mild liquor, or 6 [wines or both] 1. Name and address of the applicant . 2. Names and addresses in full of the partners, if any. 3. Name of the Hotel/Restaurant/Club/Canteen and its address in full, i.e.its exact location. 2 [4. Whether the hotel, restaurant or canteen is within a distance of seventy five meters from any educational or religious institution or from any bus stand, station or depot of the Maharashtra State Road Transport Corporation.] 5. Whether the applicant holds at present or held at any time in the past any licence for the sale of foreign liquor including mild liquor, and if so, the period during which it was held. 6. Average number of residents/boarders/ members or visitors, as the case may be, during the last one year immediately before the date of the application. 3 [7.(a) The details of amenities provided at the hotel/restaurant/canteen/club and in the case of a club the objects and activities thereof,] (b) 4* * * * 5 [(c) Carpet area of hotel/restaurant/canteen where consumption of mild liquor will be allowed and how many persons are/can be provided with sitting accommodation at a time, 1. Ins. by G. N. of 1-12-1971. 2. Subs. by G. N. of 25-3-1981 3. Subs. by G. N. of 30-12-1976. 4. Deleted by G. N. of 25-3-1981. 5. Subs. by G. N. of 30-3-1977. 6. Ins. by 28-12-2001. 1949 : Bom. XXV] Bombay Prohibition Act, 1949 (d) What is the carpet area of the hotel/ restaurant/canteen excluding kitchen, clock-room, etc., which is not used for customers ? (e) Whether the establishment has a separate kitchen, and attached clock-room provi- ding wash-basin & urinal facilities ; (f) Whether the establishment has provision for serving snacks, eatable etc.; (g) Whether the establishment has separate store room adjacent to the proposed licensed premises for storage of mild liquor 2 [or wines or both.] 8. The grade, if any, in which the hotel/ restaurant/club/canteen is classified and the authority for such classification, if any. 8A. 1 * * * * * * 9. Proof of solvency of the applicant. 10. Whether any Excise/Police/Municipal Licence held by the applicant was sus- pended or cancelled at any time in the past, and if so, the period of such sus- pension or cancellation and the reasons therefor. 11. Whether the applicant is in Excise arrears or in arrears of any other Government dues, such as Sales Tax, Income Tax etc. I, hereby declare that the particulars given above are correct. I, hereby undertake to abide by the conditions of the licence and the provisions of the Bombay Prohobition Act, 1949, and the rules, regulations and orders made there- under from time to time. 855 Date : Signature of the applicant To The Collector of ........................................ ] 1. Deleted by G. N. of 25-03-1981. 2. Ins. by 28-12-2001.