FORM "CERTIFICATE"
[See rule 25 (3)]
Dated ....................
Certified that ME/Mrs./Miss/Messers of who has/have been granted an export pass No dated by has/have delivered the Indian-made foreign liquor as shown below on to of...................................... in the district of in the State of
| Description of Indian made duty paid imported foreign liquor | Number of packages or receptacles | Quantity delivered Litres | Strength | Proof | Remarks |
|---|---|---|---|---|---|
and that the seals of the packages and receptacles containing the above foreign liquor were intact at the time of delivery of the consignment at its destination.
1[Y*2. The importer has paid all duties and fees leviable under the Bombay Prohibition Act, 1949 on the quantity of Indian-made foreign liquor mentioned in the export pass, according to the rates prevailing in this State.]1
Signature and designation of the Excise Officer at the importing place.
* Strike off if not applicable.