FORM P. L., X

: Bom. XXV] Bombay Prohibition Act, 1949 FORM P. L., X [See rule 20 (1)] ORIGINAL DUPLICATE TRIPLICATE Application No. of 20 Application for clearance of potable liquor 1 [on payment of duty or under bond] Manufactory of ............................................... No. and date of entry in the Description of potable liquor register in Form P.L., VIIIBatchVariety of No. of bottles of Manufactory No. liquorLitres 750 375 180 * * * ml. ml. ml. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Description of potableMarks and Purpose forRemark liquor number of which containers Amount of duty paid cleared StrengthProof litres Rate ofAmountChalan dutyof dutyNo. and paid date (11) (12) (13) (14) (15) (16) (17) (18) 1.Subs. by G.N. of 18-5-1974. *Here mention bottles or vessels of any other capacity allowed by the Commissioner to be filled in. 642 Bombay Prohibition Act, 1949 [1949 : Bom. XXV FORM P.L., X—contd. I declare that the above particulars are true and correctly stated.I apply for leave to clear the above potable liquor for the purpose stated in column 17 above. Place : Date : (Signature of the licensee or his authorised agent) To, The Manufactory Officer, .................................................... ———————————— (Please see reverse) Reverse Certified that the particulars given in the Application No. of 19 , on the reverse of this have been verified and found correct.The consignment(s) as detailed in the application have been permitted to be cleared from the Manufactory and allowed to be exported/transported to ........................................................................... under Export Pass No. Transport Pass No. ................................................... dated .................................................... Issued by ...................................... Manufactory Officer.