(iii) Whether the applicant was holding or was granted a licence in Form F. L. B for retail sale of foreign liquor but was not operating on the 1st January 1979 and if so, state reasons therefore.
I/We hereby declare that the particulars given above are correct.
I/We hereby enclose a Chalan No _____ dated _____ evidencing payment of a sum of Rupees _____ (Rupees _____________________) for the application.
I/We hereby undertake to bide by the conditions of the licence and the provisions of the Bombay prohibition Act, 1949, and rules, regulations and orders made there under from time to time.
I/We hereby further undertake to surrender the licence and agree to its cancellation, if considered necessary by the Government if it found at a subsequent stage that the information furnished by me / us is false.
Signature of the applicant
Date ________________
Signed before me
Notaries/Special Executive Magistrate / Tahsildar
♦ The Secretary to the Government of Maharashtra.
Home Department (Transport,) Mantralaya, Bombay 400 032
(through the Collector of _____________________)
The Collector of ____________________________)
- When the application is for a grant of licence.
+ When the application is for renewal of the licence.