1[FORM F. L. /A-IB] (See rule 24) Form of application for a vendors licence for sale of foreign liquor.

1. Name, age and addresses of the applicant. 2. Names, age and addresses in full of the partners, if the applicant is a partnership firm (copy of the Deed to be appended). 3. Exact location and full address of the premises where the business will be conducted. 4. Whether the proposed premises referred to at item 3 above are(a) Within 50 meters from any educational or religious institution if they are within the jurisdiction of any Municipal Corpo-ration or A Class or B Class Munici-pal Council and 100 meters if situated elsewhere, and (b) Within 50 meters from any bus stand, station or depot of the Maharashtra State Road Transport Corporation. 5. Where the applicant or any member of his family (or any of the Partners) holds on the date of this application or held at any time the past (individually or in partnership with any other person) any excise licence(s) held and also the period(s) for which he held it (them). Explanation: - For the purpose of this clause, Family means a person or his spouse (or more than one spouse) and his children solely dependent on him for their maintenance. 6. Whether the applicant holds the solvency certificate or bank solvency certificate or bank guarantee. If so, given particulars with copy there of duly certified by Notaries, Special Executive Magistrates or Tahsildars. 7. Present occupation and income here form 8. Whether the applicant has is in arrears of excise or any other Government dues. 9. Whether the applicant has experience of conducting liquor trade and if so, state details with documentary evidence in support. 10. Whether the applicant belongs to any of the following categories, and if so, produce proof in support (i) Whether the applicant belongs to economically weaker section (ii) Whether the applicant has in his possession ready premises for the proposed shop of if so, detail thereof. (iii) Whether the applicant was holding or was granted a licence in Form F.L.II for retail sale of foreign liquor but was not operating on 1st January 1979 and if so, state reasons therefore. I/We hereby declare that the particulars given above are correct. I/We hereby enclose a Chalan No. dated evidencing payment of a sum of Rupees.............................................. (Rupees ... ..) for the application.

I/We hereby undertake to bide by the conditions of the licence and the provisions of the Bombay Prohibition Act, 1949, and rules, regulations and orders made thereunder from time to time. I/We hereby further undertake to surrender the licence and agree to its cancellation, if considered necessary by the Government if it found at a subsequent stage that the information furnished by me / us is false. Signature of the applicant

Date Signed before me Notaries / Special Executive Magistrate / Tahsildar To, * The Secretary to the Government of Maharashtra Home Department (Transport,) Mantralaya, Bombay 400 032 (Through the Collector of ) ______________________________________________________________________________ _ + The Collector of .. ______________________________________________________________________________ _ * When the application is for a grant of licence. + When the application is for renewal of the licence. ______________________________________________________________________________ ___