Form of Receipt
| S.No. |
| Received from |
| an application for an emergency permit for liquor. |
| Dated: |
| Signature of the officer receiving the application. |
| The applicant is requested to present personally this receipt, on |
FORM ELIA-3
(or Office use only)
| Received the application | Action taken — |
| Date: | Date of registration |
| Called on | Permit prepared on by |
| Checked by | |
| Permit ready for deliveiy on | |
| Received Permit No. on |
Signature of the Applicant.
Seen.
Filed.
Signature of the permit-issuing authority.
|Name and address in full to be filled by the applicant.