FORM D.S.PL-4

(See rule-15)

(Import pass for denatured spirituous preparations)

PART-II

To be forwarded to the Collector or Chief Excise Authority of the place of export.

No. _________________ Date __________ 19 __________

Shri / Shris _________________________ of _________________________

holding

D.S.P. licence (if any), No __________ of __________

is / are hereby granted

a pass under and subject to the provisions of the Bombay Prohibition Act, 1949 (Bom. XXV of 1949), and the rules, regulations and orders made there under authorising him / them to import __________ litres/bottles of the following denatured spirituous preparations namely :—

from __________ of __________ to __________

his / their shop/premises situated at __________ via __________ (route), subject to the following conditions, namely :—

The pass shall remain in force upto __________
The quantity of denatured spirituous preparations shall be imported in one consignment only andits bulk shall not be broken in transit.

Collector of __________

PART-IV

To be sent to the Superintendent or District Inspector for being forwarded to the Local Prohibition and Excise Officer to examine the consignment on its arrival.