7931949 : Bom. XXV] Bombay Prohibition Act, 1949 FORM F. L. XII [See rule 83 (10)] Licence No. Licence for the dispensing of brandy and rum as one of the ingredients of any medicine on prescription Licence is hereby granted under and subject to the provisions of the Bombay Prohibition Act, 1949 (Bom. XXV of 1949), and the rules, regulations and orders made thereunder to ............................................... of ................................... (hereinafter referred to as “the licensee”) on payment of a licence fee of Rs. ...................... authorising him to dispense brandy or rum as one of the ingredients of a medicine at his shop/dispensary situated at ............................................ (hereinafter referred to as “the licensed premises”) during the period from ........................................... to .................................. on the following
conditions, namely : Conditions 1.(a)The licensee shall not keep in his possession any quantity exceeding ........................................ of brandy and rum, each at any one time. (b)The licensee shall not purchase more than ............................. quart bottles of brandy or rum, each during any calendar month. 2.The licensee shall not keep or dispense brandy or rum at any place other than the licensee premises.He shall not prescribe or dispense brandy or run except as one of the ingredients of the medicine. 3.The licensee shall not keep in the licensed premises any intoxicants which he is not authorised to dispense under this licence or any other licence granted under any law for the time being in force. 4.This licensee shall keep affixed to the licensed premises a signboard showing the name of the licensed premises.