FORM S. W./A-1

FORM S. W. / A-1

(See rule 3)

Application for Authorisation to Purchase, Possess, Consume and Use Wine and/or Liquor for Sacramental Purposes

To,
The Collector of ______ District

I, ______ residing at ______ apply for an authorization under the Bombay Sacramental Wine Rules, 1950, to purchase, possess, consume and use wine and/or liquor for sacramental purposes. Details in support of this application are given below:

1. Name and address of the applicant.
2. Community to which the applicant belongs and religion / sect followed.
3. Whether the applicant holds any religious office; if so, the nature or description of such office / designation.
4. Total quantity of wine / liquor to be used.
5. Place where the wine / liquor is to be kept.
6. Place where the wine / liquor is to be used.
7. The occasions on which religious ceremonies are to be performed requiring the use of wine / liquor.
8. Whether any such authorisation was held during a period of three years immediately before the date of the application; and if so, the number and date of such authorization together with the quantity of wine / liquor permitted each year.
9. Whether the wine / liquor used during the three preceding years was imported wine / liquor or locally-manufactured wine / liquor; the place from where such wine / liquor was obtained; evidence, if any, in support of the quantity of wine / liquor so purchased during each of the three years.

Place: ______                                     Signature of the Applicant

Date: ______

Submitted to the Collector of ______ through:

Recommendation of the religious head or the approved person residing at:

This is to certify that ______ belongs to (state the community) and follows (state the religion and sect), according to the religious tenets of which he has to perform religious ceremonies on the occasions cited in the application. I have scrutinised the application and recommend that the applicant may be granted an authorization to use ______ (quantity) of wine / liquor for sacramental purposes at ______ (place) during the period from ______ to 31^st March ______.

Signature ______    Dated: ______    Designation ______

* Strike off if not applicable. + State the name, designation and address of the religious head who exercises control over sacramental matters relating to the community to which the applicant belongs and who has been approved by the State Government under section 45 of the Act. If there is no such religious head, the name of any member of the community approved under section 45 may be stated. An applicant who is himself the religious head or an approved person should submit the application duly certified by him to that effect.