FORM F. L. IV-A

HRTRTTTY7 TFTA 
HTUTTUT 4T7 T-4, 
fgHr , 2o?19/utu 3, TR3 
I hereby 
undertake to abide by the conditions of the licence and the provisions 
of the 
Maharashtra Prohibition Act [BOM. KXV of 1949] and the rules, regulations 
and orders made 
thereunder from time to time. 
Signature of the applicant. 
Date: 
To, 
The Superintendent, State Excise of.. 
FORM F. L. IV-A 
(See rule 48C) 
Temporary Licence for the sale of imported foreign liquors (potable) 
and Indian-made 
foreign liquors (potable) 
on uwhich excise duty has been paid 
at special 
rates at a 
special function or event. 
Licence is hereby granted under and subject to the provisions of the Maharashtra 
Prohibition Act (BOM. XxV of 1949) and the rules regulations and orders made thereunder 
. 
(hereinafter referred to as the "Licensee"), 
on payment of a fee (inclusive 
in advance, authorizing him to sell the following 
at a registered premises (hereinafter referred to as the licensed 
LO.... ***.*********** 
of eonsiderationi of Rs. .. '***** ******"******* 
foreign iquors on... 
premises having ID#... 7************* .. during.. . to........ at a special function/event ap-
plied for, subject to the following conditions, namely 
Foreign Liquors 
(a) Wines 
(b Fermented liquors 
(c) Spirits 
(d) Mild-liquors 
Conditions 
1. The licensee shall not sell foreign liquor except in accordance with the provisions of rule 
52 of the Bombay Foreign Liquor Rules, 1953. 
2. The licensee shall not sell or serve foreign liquor except to valid permit holders. 
3. The licensee shall not sell or serve foreign liquor except at the designated area at the 
registered premises. 
4. No foreign liquor other than that sold by the lieensee shall be allowed to be consumed in 
the said licensed premises.

5. The licensee shall not receive as consideration or a part thereof for the sale of any foreign 
liquor any wearing apparel or ornament8 or any other thing except coins, currency note or cheques. 
6. The stock of liquor which shall remain unsold in form of sealod bottlen nfter the function/ 
event shall be sold back by the licensce to the source of 8upply, with the previous written perrmis 
sion of State Exciso Omcer not below the rank of Sub-Inspector in whose jurindiction the licenced 
premises is located, on a special Transport Pass issued by the officer. 
7. The licence may be suspended or cancelled in accordanco with the provisions of 
section 54 or 56 of the Maharashtra Prohibition Act. 
8. In case this licence is cancelled or suspended during the currency of the licence period, 
the licensee shall surronder the whole stock of unsold foroign liquor forthwith to the State Excise 
authorities. The stock of liquor so surrendered shall be sold by the Superintendent, State Excise 
and the proceeds of the sale shall after deducting the expenses and any sum due to State Govern-
ment be returned to the licensec. 
9. The liconsee shall comply with all orders and instructions issuod to him by the State 
Excise Oficers not lower in rank than a Sub-Inspector of State Excise. 
Granted this day of 20 
Seal. 
Superintendent, State Excise 
By order and in the name of the Governor of Maharashtra, 
P. H. WAGDE 
Joint Secretary to Government.