FORM KL/A-6-B1
Application No.
Application for a permit for the purchase, possession, transport, use and consumption of Foreign Liquor and Country Liquor in the State of Maharashtra.
- Name in full Shri/Smt/Kum (Surname first in Block letters)
- Residential address in full
- Age and date of birth
- Details of proof of age produced with this application
- Occupation
- 2[* * * * * *]2
3[I hereby declare that I require foreign liquor and country liquor on grounds of health and in support of my application. I submit herewith the medical certificate in Form FJL/M.C. I signed by Dr _________________ Registered Medical Practitioner.]3
I hereby undertake to abide by the conditions of the permit and the provisions of the Bombay Prohibition Act, 1949 and the rules, regulations and orders made there under.
Place: Signature or thumb impression of
Date: the Applicant.
The Collector of __________________________ (or authorised Officer.)
4[FORM EL.X-B]4
(Deleted)
5[FORM ELJ.A-6-C]5
(See rule 70-F)
Court Fee Stamp Application No.
Application for a permit for the purchase, possession, transport, use and consumption of mild liquor in the State of Maharashtra.
- Name in full Shri/Smt/Kumari (Surname first in block letters)
- Residential address in full