FORM C.L.A
[See rule 3(1) and rule 4(2)]
Application
for Licence to manufacture Country Liquor
(delete to portion not applicable)
TO
The Commissioner of Prohibition and Excise,
Maharashtra
State
,
Bombay
.
Sir,
1.
I/We …………………………………….. of ……………………..
May be granted
(here full address) request that I / We -----------------------
licence t manufacture country
The accompanying
During the year
Liquor ------------------------------------- ending
on the 31st March 19
May be renewed for period
2.
I / We hereby declare particulars ( in the tale overleaf) of the Manufactory
and the premises here I / We intend to carry on
business for the manufacture
of country liquor.
3.
I /We hold licence No. …………… for construction and working a distillery for the
manufacture of sprit valid up to ……
……………………….]
or/I/We hold licence No. ……………………………….. for the possession and Use of Rectified
Spirit
valid
up to ……………………………]
4.
I / We agree to abide by the terms and conditions of the license which may be
granted/ renewed, and the provisions of the
Bombay Prohibit
ion Act, 1949, and the rules, regulations
and orders made thereunder.
5.
I/ We have enclosed in quadruplicate the sit and elevation plans of the manufactory
premises, together with relevant records.
6.
I/We enclose four signed copies of the process which I/We desire to adopt for
the manufacture of each variety of country
liquor.
7.
I/We enclose a Chalan No. ………………………….. dated……………………….
Evidencing payment of a sum for 2[Five hundred
rupees (Rs. 500)] for the application.
8.
I / We hereby declare that no excise licence previously held by me/ us has been
revoked or suspended or has failed t be
reneweowingt breach of the Act,
rules , regulations , notifications or orders governing the grant of such licence.
9.
I/We declare that to the best of my/our knowledge and belief, the information
furnished herein is true and complete.
Place……………………..
Dated………………………..
Signature/s of the
applicant/s