FORM F.L. XIV

Appointment from the 19 named and appointed for period to the 19 mentioned in the margin to officiate for me/us in respect of the functions, that is to say, namely:

1. to officiate for me/us at my/our licensed premises/shop at ............ and
2. to transport foreign liquor.
3. The said person is competent in my/our absence to conduct my/our above mentioned duties in accordance with the provisions of the said rules. He is of good character; and a far as I/We know, he has not been convicted of any offence under the Bombay Prohibition Act, 1949; nor has been convicted by a Criminal Court of Black listed in respect of excise licence, rendering him unfit for an appointment as Nokan
4. I/We have explained to him personally all the conditions of my/our licence; and I/we hold myself/ourselves responsible personally for any offences he may commit in the conduct of the business under my/our licence.
5. his Nokamama shall become invalid on the suspension, cancellation or expiry of my/our licence or if a competent officer refuses counter signature thereon. The Nokamama will also become invalid, if the Collector concerned issues me order to that effect. This Nokamama shall be kept with the employee.

Signature of the licensee

Dated 19

The sum of Rs. 1 only as the fee prescribed for the issue of this Nokamama has been paid, vide Chaian No.................................. dated ........ ...................

Treasury/sub-Treasury/Reserve Bank/State Bank-

Dated 19 Signature of the licensee.

1. The appointment of the above named Nokar is noted.
2. The Nokamama shall be in operation till the 19 but it is liable to cancellation for any breach, on the part of the nominee of the provisions of the Bombay Prohibition Act, 1949 or any rules made there under or for any other offence rendering him unfit to hold the appointment hereby made.

Signature and designation of

Dated the 19 Prohibition and Excise Officer.

¹