FORM -A,

Whereas I/we residing at ...............................in the in the taluka/tahsil/mahal of the district have made an application on .............................................................to .................... ..... fora pass authorising me/us to transport in bond/export in bond the Indian-made foreign liquor specified in the Schedule hereto annexed (herein after referred to as " the said Indian-made foreign liquor*') from the bonded warehouse at to the Customs Station at ....................................................................... for dispatch to ......... ... .... ......... .................................................. '¹[I/we bind myselYourselves]¹ that I/we shall cause the said Indian-made foreign liquor to be duly and safely transported/exported from the bonded warehouse at and conveyed by the most direct route to the Customs Station at aforesaid in conformity with the provisions of the Bombay Prohibition Act, 1949, and the rules and orders made there under and shall cause the said Indian-made foreign liquor to be delivered into the custody of the Customs Office at the Customs Station of and shall obtain and produce before the Collector of* ............................................. within ______________________ days from the date of this bond a certificate signed by the officer-in-charge of the said Customs Station showing the quantity of the said Indian-made foreign liquor despatched from the said Customs Station to the place aforesaid.

And if the whole quantity of the said Indian-made foreign liquor is not certified to have been received at the Customs Station for being despatched to the said place, I/we shall on demand by the said Collector of* ................................ pay or cause to be paid within seven days from the date of demand to the said Collector duty at the rates in force at the time of the issue of the pass or at the time when the shortage was noticed, whichever the Collector decides to demand, on such quantity of the said Indian-made foreign liquor as has not been so delivered for dispatch to the Customs officer-in-charge of the said Customs Station.

And in case of my/our failure to pay the amount of the said duty within the said period of seven days. I/we shall pay interest on the said amount at the rate of 12 percent per annum from the date of demand to the date of payment and in the event of my/our making default in the payment of the said duty and the amount of interest due, if any, I/we bind myselfYourselves to forfeit to the Governor of Maharashtra the sum of Rs in guarantee of which I/we have deposited with Government an amount of Rs in cash/in securities.

• - Here insert the name of the place from which transport or export takes place.
• 1 Subs by G N. of 19-7-1969.