FORME

We¹(1) (2)¹

...................................................................................... residing at

............ .................... ........................... —----------- ....... .....in the

talukaof district.

do hereby declare ourselves sureties for the above named

that he/they shall do and perform all that

he/they has/have undertaken to do and perform, and in case of his/their making default

there in, we hereby bind ourselves, jointly and severally, to forfeit to the Governor of

Maharashtra the sum of rupees

Place

Dated this day of 20 .

In the presence o —

Signature of sureties,

FORME

[See rule 11]

Pass for the Import-in-Bond of Indian-made foreign liquor

PART I

(fbr record in the office of the Collector)

No of 20 -

Mn/Messrs having executed a bond

fbr the payment of the amount of duty leviable under the Bombay Prohibition Act, 1949,

on the undermentioned description and quantity of Indian-made foreign liquor, is/are

hereby permitted to import subject to the terms of the bond the said foreign liquor from the

Distillery

Brewery at in the district of in the state of

Warehouse

licensced shop N。.

................................. to his/their House No situated at

Bonded Warehouse

in the Greater Bombay*

the District of