FORM S.W. III

FORM S.W. III

PART I

Pass for transport of sacramental wine

(To be retained by the Officer in-charge for his record)

1. Serial No.
2. Name and Address of the licensee from whom the sacramental wine is to be transported.
3. Quantity of sacramental wine to be transported.
4. No. of authorisation held by the consignee licence
5. Name and Address of the consignee.
6. Route.

This pass is granted under and subject to the provisions of the Bombay Prohibition Act, 1949 and the rules made there under authorising the transport subject to the following conditions, namely:

1. The consignment shall not be broken in transit.
2. This pass will remain in force upto.................................................... 20 .

Date .......... Signature and Designation of the Officer issuing the pass.

Seal of the Officer issuing the pass

Compared with the Part II on........................................................ 20

Signature of the Officer issuing the pass.