FORM-H

Whereas I/We residing at _____________________ in the taluka of the _____________________ district _____________________ have made an application on _____________________ to _____________________ for the pass authorising me/us to export in bond Indian-made foreign liquor as specified in the said application from _____________________ in the district of _____________________ to _____________________ in the district of _____________________ in the State of _____________________ I/We bind myself/ourselves;

that I/we shall cause the quantity of foreign liquor mentioned in the pass to be duly and safely exported from the State of Maharashtra and convey it by the most direct route from _____________________ to _____________________ aforesaid in conformity with the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made there under and shall cause the said foreign liquor to be delivered into the custody of _____________________ at _____________________ in the district of _____________________ and shall procure and produce to the Collector within three months from the date of this bond a certificate signed by the Excise Officer _____________________ aforesaid showing what quantity of the said foreign liquor specified in the pass has been so delivered at the place aforesaid;

and that if the whole quantity (after deducting the allowance due to loss on account of wastage dryage and leakage in transit not exceeding ¹[0.3 percent for every 10 kilometres]¹ of the distance by the most direct route between _____________________ and _____________________ ) shall not have been certified to have been delivered to the _____________________ at _____________________ aforesaid, I/we, my/our heirs, executors, administrators and representatives shall on demand by the Collector pay or cause to be paid within seven days from the date of demand to the said Collector or Officer duty, transport fee and special fee mentioned in the Bombay Foreign Liquor and Rectified Spirit (Transport) Fees Rules, 1954 at the rates in force on such portion of the foreign liquor specified in the pass as shall not be so delivered after making allowance as aforesaid but irrespective of the fact whether such foreign liquor or any other part thereof has or has not actually been so exported ;

and that in the event of my/our failure to pay the amount of the said duty and fees within the said period of seven days I/we shall pay interest on the said amount at the rate of 12 per cent. per annum from the date of demand to the date of payment.

And in case of my/our making default in the payment of the said duty, fees interest and other charges, if any, I/we bind myself/ourselves to forfeit to the Governor of Maharashtra, the sum of rupees _____________________