No of 19 .
Mn/Messers having paid into the Government Treasury at the sum of Rs ( ) only on account of duty on the undermentioned description and quantity of Indian made foreign liquor is/are hereby permitted to import the said liquor from the at in the district of in the State of to his/their situated at the District of Greater Bombay.
| Description of Indian-made foreign liquor | Litres | Quality | Strength (to be specified in case of spirits only) | Proof litres |
|---|---|---|---|---|
The consignment shall be conveyed by rail/road via shall be inspected en route at * by and on arrival at the destination shall be examined at † by it shall not be broken in transit.
This pass shall remain in force upto p.m. of the ______ day of.. 19 .
This pass is issued subject to the provisions of the Bombay Prohibition Act, 1949 the rules and orders made there under and the conditions specified in this pass.
(Signature) Dated 19 . Collector
This pass, together with part III, is forwarded to the Excise Officer of (Signature) Dated 19 Collector.
Remarks if any, of the officer who inspects the consignment en-route and copy of the impression of the seal, if any, used in rescaling the consignment.