FORM S·W—contd.

FORM S·W—contd.

PART II

Pass for transport of sacramental wine

(To be handed over to the licensee who shall retain for the 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.
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 rule 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

Issued the above quantity on 20

Signature of the licensee.