FORM A

Bombay Prohibition Act, 1949 [1949 : Bom. XXV FORM-A (See rules 4 and 10) Application for pass to import duty-paid imported forign liquor Indian-made foreign liquor Place ............................... Date ................................ To, The Collector of ............................... Sir, 1 [I/We ............................................................... of ................................................................... holding licence/permit No. ................................ valid up to ............................................................... under the Bombay Prohibition Act, 1949, for possession and/or sale of duty-paid imported and/or Indian-made foreign liquor, request you to grant]. me/us a pass for the import of the undermentioned kind and quantity of duty-paid imported forign liquor from Indian-made foreign liquor the shop/house distilery bre wery warehouse situated at ............................................ in the district of ..................... ................................................ in the State of ................................................................................ to my/our shop or house No. bonded warehouse situated at ....................... in Creater Bombay the District of*................. ....................... in bond/* ................................ on payment of duty in the State of Maharashtra. ___________________________________________________________________ Quantity and Kind of foreign alcoholic strength liquor Quantity Strenegh Proof litres Remarks ___________________________________________________________________ ___________________________________________________________________ I/we furnish the requisite information as follows, namely :— (1) Route by which foreign liquor is to be imported ................................................... (2) Name and address of my/our agent, if any, at the exporting place ...................... (3) Purpose for which foreign liquor is to be imported ............................................... (4) Period of validity of the pass required ..................................................................... 1. Subs. by G. N. of 8-9-1965. 1949 : Bom. XXV] Bombay Prohibition Act, 1949 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). *Strike off the words which is not applicable ____________