FORM D.S.B -5

Shri / Sarvashri .......................................................____ ....... of holding .............................................. D.S.R licence 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 order made there under authorising him / them to export . litres/bottles of the following denatured spirituous preparations, namely:―

from .................................... ................................— ............— .......----- ............... o£ ........................... to.......— his/their shop/premises situated at............................................................. ............. .......................... via .................................................................. (route), subject to the following conditions, namely:—

1. The pass shall remain in force upto ................................................----------------- ....
2. The quantity of denatured spirituous preparations shall be exported in one consignment only and its bulk shall not be broken in transit.

Seal Collector of ........................ ....

¹

FORM D.S.R-5

(See Rule-20)

(Export pass for denatured spirituous preparations)

Part-II

To be handed over to the exporter for sending it with the consignment of denatured spirituous preparations.

Serial No. ,dated 197 .

Shri/Sarvashri -------- .......holding D.S.R licence No. ............. .... 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