Grievances

[I hereby declare that I require foreign liquor and country liquor on grounds of health and in support of my application.I submit herewith the medical certificate in Form F.L./M.C. I signed by Dr. .................................................................................................... Registered Medical Practitioner.] I hereby undertake to abide by the conditions of the permit and the provisions of the Bombay Prohibition Act, 1949 and the rules, regulations and orders made thereunder. Place : Signature or thumb impression of Date : the Applicant. To The Collector of ................................ (or authorised Officer.)] [FORM F. L. X-B] (Deleted)

[FORM F. L./A. 6-C] (See rule 70-F) Application No. Application for a permit for the purchase, possession, transport, use and consumption of mild liquor in the State of Maharashtra. (1)Name in full . .Shri/Smt./Kumari ................................................. (Surname first in block letters) (2)Residental address in full. ................................................................................. Court Fee Stamp Court Fee Stamp 1Subs. by G. N. of 8-8-1979. 2Deleted by G. N. of 4-5-1982. 3Subs. ibid. 4Deleted by G. N. of 8-8-1979. 5Ins ibid.