I request that a transport pass for the above quantity of rectified spirit may be issued to me.
I hereby undertake to abide by the conditions of the transport pass and the provisions of the Bombay Prohibition Act, 1949, and the rules, regulation and order made there under.
Place:
Date:
Signature of the applicant.
The Collector of ..........................
Through the District Prohibition and Excise Officer ..........................
1[FORM R.S. IV]1
[See rule 20 (2)]
Pass for the transport of rectified spirit (including absolute alcohol) from the licensed premises of a person holding a sale licence or from a Government warehouse or distillery 2[or any licensed distillery or warehouse]2 to the licensed premises of a licensee holding a licence in Form R.S. H, 3[R.S. I or R.S. VI-A]3.
(Counterfoil).
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