FORM [FORM TITLE]

Special permit for the possession of¹*¹ ..............................................................................

Permit No.

Permit is hereby granted, under and subject to the provision of the Bombay Prohibition Act, 1949 (Bom. XXV of 1949), and the rules, regulations and orders made there under to of (herein after referred to as the [Permit holder authorising him to possess [herein after referred to as the "articles"] as shown in the] Appendix hereto annexed at his premises situated at during the period from to (both days inclusive), subject to the following conditions, namely-

Conditions

The permit-holder shall not possess under this permit any articles other than those specified in column (1) of the Appendix or in quantities exceeding those specified against each of them in column (2).

The permit- holder shall keep all such articles in his custody until they are disposed of within the time and in the manner permitted by the Collector in that behalf. The articles while in the custody of the permit-holder shall be kept sealed with the seal of the Collector.

The permit-holder shall exercise all due and reasonable precautions to ensure that the seal of the Collector is not broken, removed or otherwise tampered with except by a person duly authorised in that behalf by the Collector.

The permit- holder shall not dispose of the articles in a manner other than that permitted by the Collector in writing.

This permit is non-transferable.

The permit-holder shall comply with all lawful orders issued to him by the Collector or the Superintendent or District Inspector of Prohibition and Excise of his disrict.

The permit-holder shall abide by the conditions of this permit and the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made thereunder and shall give an undertaking to that effect.

The permit may be suspended or cancelled in accordance with the provisions of section 54 of the Bombay Prohibition Act, 1949.

In case the permit is suspended or cancelled, the stock of the articles in the possession of the permit-holder on the date of such supension or cancellation shall forthwith be surrendered by him to the Collector.

Appendix

Articles	Quantity

Granted this day of 19.

Seal of the

Collector Collector.]

- Here specify the articles held by the permit-holder without any licence, permit, pass or authorisation before such holding was rendered unlawful.

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