4. Application for Licence for Possession and use

Kind of spirit	Quantity and description of the spirit—				Amount to fees paid
Kind of spirit	¹[Dozen bottles each of 11 [Proof litres]]¹	¹[Dozen bottles each of 750 millilitres]¹	¹[Dozen bottles each of 500 millilitres]¹	¹[Dozen bottles each of 250 millilitres]¹	Pass Fee Rs. P.	Special Fee Rs. P.	Total Fee Rs. P.
Rectified Spirit
Absolute Alcohol

Route.
Name and address of the person holding a sale licence or Government warehouse or distillery.
Number and date of the requisition order.

The purpose for which rectified spirit is to be transported.

Date up to which the pass shall be valid.

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

The consignment shall not be broken in transit.

Dated:

Signature of the Officer issuing the pass.

Designation ...........................

Seal of the Officer issuing the pass

* These particulars are not to be given in the case of transport of rectified sprit by a person holding, a licence m Form R.S.H, incidental to its purpose from person holding a sale licence in Form R.S.VI
These particulars are not to be given in the case of transport of rectified sprit by a person holding, a licence m Form R.S.H, incidental to its purpose from person holding a sale licence in Form R.S.VI

¹ Ins. by G N. of 26-9-1966.

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