1[FORM F.L.A-ID
(See rule 47)
From
of application for a licence for the sale at a club of imported foreign liquor (potable)
and Indian-made
foreign liquor (potable) on which excise duty has been paid.
1. Name and address of the club
2. Names
and addresses in full of the Secretary
and other office bearers of the club.
3. Exact
location and full address of the club.
4. Whether
the club holds on the date of this
application or held at any time in the past
any
licence for the sale of foreign liquor and if
so,
the period during which it was held.
5. Average
number per day of resident members
or visitors, s the case may be, during the last
one year immediately before the date of the application.
6. Number
of members
7. The
details of the total accommodation of the
club and the amenities provided therein, and
the activities and objects of the club.
8. Rules
of the club relating to the election of
members, terms of subscription, entrance fee,
if any, hours of opening and closing.
9. Number
of rooms assigned for the sale of foreign liquor.
10. Whether
any excise/police/municipal licence
held by the club is or was suspended at
anytime in the past, and if so, the period of
such suspension and the reasons for such suspension.
11. Whether
any excise/police/municipal licence
held by the club is or was cancelled at any
time in the past, and if so, the reason for
such cancellation.
I hereby declare that the particulars given above are correct.
I hereby undertake to abide by the conditions of the licence and the provisions
of the
Bombay
Prohibition Act. 1949, and the rules,
regulations and orders made there under
form time to time.
Date :
Signature
for the applicant.
To
The Collector of ………………………………]