नाशिक विभाग

[ FORM ‘A’ ] Special permit for the possession and use of*…………………………………for Medicinal, Scientific, Research, Educational and such other purposes. Permit No. Permit is hereby granted, under and subject to the provisions of the Bombay Prohibition Act, 1949 (Bom. XXV of 1949), and the rules, regulations and order made thereunder, to .................................. of ................................................................ (hereinafter referred to as the “Permit-holder”) authorising him to possess and use * ....................... at his premises situated at ............................................................................ during the period from ...................................................... to ........................................................ (both days inclusive) subject to the following conditions, namely :— Conditions

1. The permit-holder shall not have in his possession* ....................................... in quanitity ......................................... exceeding at any one time.

2. Unless as otherwise permitted by the Commissioner, the permit-holder shall not obtain* ........................................ except from a person holding a licence for its/their sale under the Bombay Prohibition Act, 1949.

3. The permit-holder shall not obtain* .................................... in ...................................... quantity exceeding ................................................... during any calendar month.

4. The permit-holder shall not use* ..................................... possessed by him under this permit except for the purpose of ...............................................................................

5. This permit is non-transferable.

6. In case the permit is suspended or cancelled during its currency or is not renewed on its expiry, the whole stock* ............................. in balance with the permit holder on the date of such suspention, cancellation or non-renewal, shall forthwith be surrendered by him to the Collector.

7. The permit-holder shall comply with all lawful orders issued to him by the Collector or the Superintendent

[or District Inspector of Prohibition and Excise] of his district. 8. The permit-holder shall abide by the conditions of this permit and the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made there- under and shall give an undertaking to that effect. Granted this .................................................... day of ...................................................... 19.

Seal of the Collector Collector.

• Here specify the name of the intoxicant mhowra flowers or molasses as the case may be. 1. Ins. by G. N. of 10-8-1955.

2. Ins. by G. N. of 25-7-1963.