FORM C.L. XV

(To be handed over to the importer or his agent for presentation to the Excise Officer of the exporting place and on arrival of the consignment at the place of import to Examining Officer)

No of 20

Shri/M/s having paid in to the Government Treasury at the sum of Rs (Rs ) only on account of duty on the under mentioned description and quantity of country liquor is/are hereby permitted to import the said country liquor from the Distillery at ..................... in the district of in the state of ...................

to his/their wholesale (Trade) licensed premises No situated at Greater Bombay in the district of

The consignment shall be conveyed by rail/road, via.......................................... shall be inspected en-route at by^* and on arrival at the destination shall be examined at by^** at it shall not be broken in transit.

This pass shall remain in force upto the day of

This pass issued subject to the provisions of the Bombay Prohibition Act, 1949, the rules, regulations and orders made there under and the conditions specified in this pass.

(Signature) ............................. Collector;---------- — District

Dated _______________ 20 .

Remarks if any, of the Officer who inspects the consignment en-route and copy of the impression of the seal, if any, used in resealing the consignment.