Collector of............. ____
Seal of the District.
Collector
Place.....................................
Specimen signature of the permit-holder
This is certify that Mr./Mrs./Miss (Shri /Smt./Kumari)
whose specimen signature
appears below holds a * Permit No
dated under rule + of the Bombay Foreign Liquor Rules, 1953, valid up to .................................... for the following quantity offoreign liquor:
Quantity
Specimen signature of the permit-holder ______
Seal of the
Collector
Collector of................................
Place ...................................
Dated...........................................
* please specify here the kind of permit.
+ Here specify the relevant rule.
Details ofpurchases offoreign liquor
| No. ofunits allowed P. M. | Signature of (i) the holder of a Vendor's licence or (ii) Progressive Officer -in-charge of Govt. Depot or (iii) Hotel or Club Remarks |
|---|---|
| total for the month in units | Quantity purchased in units (State Completed licensee and name of the Depot, Hotel or Club or the shop holding vendor's licence, as the case may be) |
| Date | |
| (1) (2) (3) (4) (5) (6) (7) | |
| Spirits Wines Fermented units and indicate fractions liquors by signs | |
1. Ins. by G. N. of 24-2-1956.
15 days of full content access — every Act, Rule, Regulation, GR, notification and Ex-DC-authored guide. No card required.
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