[FORM `[IL.1] (See Rule 4) Application for an import permit 1. Name of the Applicant : 2. Full address : 3. Details of licences held : 4. If the applicant is a partnership firm or company details thereof : 5. Purpose for which permit is applied for: 6. Quantity in litres, proof strength quality or make of each variety forming the consignment : 7. Place from which the consignment will start : 8. Place to which the consignment will reach : 9. Route through which the consignment passes and the mode of conveyance by road/canal/air : 10. Details of duty, if any, paid by the applicant - Challan No. and date and place of remittance in the Andhra Pradesh (original Challan whether enclosed) : 11. Probable time required for transit (Number of days) : 12. Particulars of authorisation of permit from the competent authority relating to permit applied for. Number and date and issued by whom should be stated and applicant's copy if any should be enclosed : 13. Particulars of the approval of Commissioner for the labels of each variety of liquor sought to be exported] I declare that the particulars given above are true to the best of my knowledge and belief. If at any stage it is found that the particulars are wrong or that I have resorted to fraud, I may be prosecuted. 1. Subs. by G.O.Ms. No.531, Rev. (Ex.III), dt.6-6-1994. 2. Item 13 inserted by G.O.Ms. 817, dt.27-8-87 (w.e.f.1-10-1987). I have gone through the provisions of the Andhra Pradesh Excise Act, 1968 and the rules made thereunder and bound by the provisions. I agree to pay any duty or fee that is due on the consignment if it is found that it has not been remitted or short remitted. I shall obey the rules and regulations in force within the local area through which the consign ment passes. Date: Signature of the Applicant.
