FORM C.L.XIV—Cont'd

[See rule 7 (2)]

Serial No

Pass for the transport of duty paid country liquor as detailed on the reverse

(Duplicate)

(To be handed over to the Wholesale licensee to accompany consignment)

Reference of relevant page No. of register in Form C.L.X

Name and address of the transporter.

Place to which the country liquor is to be transported.

Place from which country liquor is to be transported.

Route (i.e. by road or rail) by which country liquor is to be transported (State here the places via which the consignment will be sent.)

The consignment shall not be broken in transit. This pass shall remain in force upto and including 19_______.

Seal

Place: _________________________________

Date: __________________________________ Manufactory Officer

(Reverse)

Details of the country liquor allowed to be transported from

(Here state the name of the Manufactory)

Variety of country liquor	Strength	No. of Bottles	Total Bulk Litres
(1)	(2)	(3)	(4)

Place: _________________________________

Date: __________________________________ Manufactory Officer.

¹Deleted by G. N. of 8-8-1979¹

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