FORM G

: Bom. XXV] Bombay Prohibition Act, 1949 901 Application for a pass to export To FORM-G [See rules 22 and 26)] 1 [Indian made foreign liquor *Duty paid Indian made foreign liquor *Duty paid imported foreign liquor] Place ...................... Dated .................... The Collector of ................................... Sir, I/we ........................................................ of ........................................................ request your to grant me/us a pass for the export of the undermentioned description and quantity of 1 [Indian made foreign liquor *Duty paid Indian made foreign liquor * Duty paid imported foreign liquor] from the *distillery/brewery/bonded warehouse/shop/ house of ................................... situated at .............................................. in the district of ........................................................................in the State of Maharashtra of Mr. /Messers. ................................................................................... of........................................in the district of .............................................................................. in the State of .................................* in bond. ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––——————— Description Name and Marks and Quantity of Strength Proof Remarks of foreign description of Numbers foreign liquor of foreign litres liquor each kind of on each contained in liquor receptacle receptacle or each receptacle package package or package litres ———————————————————————————————————————————— ———————————————————————————————————————————— I/We furnish the requisite information as follows, namely : 1. Route by which foreign liquor is to be exported ............................................................... 2. Name and address of the consignee ................................................................................... 3. Purpose for which foreign liquor is to be exported .......................................................... 4. Period of validity of the pass required ................................................................................... I/We Send herewith a permit No. ................................................................................. granted by ..................................... authorising the export of the above foreign liquor to the importing place stated above. I/We agree to abide by the provisions of the Bombay Prohibition Act, 1949, the rules, regulations and orders made thereunder and the conditions on which the pass may be issued to me/us. Yours faithfully. (Signature of the Applicant). ————————————————————————————————————— 1 Subs. by G. N. of 7-7-1971. * Strike off the words which are not applicable.