FORM B

FORM B

(See rule 15)

Transport Pass for Liquor Required for the Manufacture of Medicinal / Toilet Preparations

Pass No. ______     Dated ______ 20 ______

Pass is hereby granted to Shri ______ holder of Licence No. ______ dated ______ for the possession and use of liquor for the manufacture of medicinal / toilet preparations, authorising him to transport the liquor specified below from ______ to ______ during the period from ______ to ______ subject to the conditions, namely:

1. Name and Address of the licensee.
2. Name and number of licence for possession and use of liquor.
3. Name, kind and quantity of liquor to be transported.
4. Place from and to which the liquor is to be transported.
5. Route by which the liquor is to be transported.
6. Period of validity of the pass.

The pass shall be prepared in quadruplicate: (a) one copy retained by the issuing Inspector on record; (b) one copy handed over to the licensee to accompany the consignment; (c) one copy sent by post to the Excise authority at the place of purchase; (d) one copy sent to the officer in charge of the check post or Superintendent of State Excise at the boundary of transit.

Seal                                        Signature and designation of the Inspector issuing the pass