FORM C.L. XVII
[See rules 18 and 31 (3) and condition 9 of the licence in Form C.L., II]
Pass for the transport of duty paid country liquor from the licensed premises of a person holding a wholesale licence to the licensed premises of a licensed retail shop
PART-III
(To be sent to the Inspector of Prohibition and Excise or Sub-Inspector of Prohibition and Excise as the case may be in whose jurisdiction and licensed premises of the person holding a warehouse is situated.)
- Serial No. .. ..
- Name and Address of the person transporting the country liquor.
- Licence number of the transporter.
- Quantity and Description of country liquor.
Kind of country liquor In bulk Quantity in sealed bottles 1[or containers]1 No. of litres No. of casks or 1[bottles]1 No. of casks or drums 750 ml. bottles 375 ml. bottles 180 ml. bottles Country liquor 25 U.P. .. Country liquor 40 U.P. .. - Route .. ..
- Name and Address of the person holding a wholesale licence
- Number and Date of the indent in Form C.L. XXI by the person holding a licensed Retail shop.
- Date upto 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 above mentioned transport, subject to the following conditions, namely:
The consignment shall not be broken in transit
Dated:
Signature of the Wholesale Licensee.