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Application for License in form L-12A
Applicant Details
Name* Address*
Email Id Mobile No.* +91
Venue Details
District of Function* Type of Function*
Function start date & time* Function end date & time*
No. of Days* Venue Category* Private Venue Commercial Venue
Name of Venue*
Address of Venue*
Nearest police station from venue Check if nearest police station is not known
Caterer Details
Check if No caterer service is taken
Name of Caterer* TIN of Caterer
Address of Caterer* No. of Approx. Guests*
Liquor Required
IMFL (No. of cases)
Beer (No. of cases)
Payment Details
Application Fee*

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