1.
  (i) Name of applicant
  (ii) Father/Husband’s name
  (iii) Address/Telephone # ( Please furnish proof of residence )

2. Whether individual/company/partnership firm/society etc
   (i) Name and complete address of the premises/place where the function is propsed to be held.
   (ii) Name and address of the agency/organization owning the premises mentioned above.

3. Occasion ( please specify if it is a marriage, birthday etc. Also enclose a copy of invitation card, if     available )

4. Date & Time of the function ( please specify the starting time as well as the ending time. )

5. Approx. number of people likely to attend the function.

6. (i) Quantity of liquor required
        IMFL
        Beer
   (ii) Details of the outlet from where the liquor has been purchased/ is likely to be purchased

It is certified that the information given above is correct. It is further certified that the liquor to be served in the party would not exceed the limit fixed by the competent authority and would be purchased from authorized sources in Delhi.

Date :
Signature of Applicant