has made application for a

in the

license to sell intoxicating liquors
and it having
been made to appear to the board of license commissioners that
the said
has complied with the provisions of the
Ordinance in that behalf, this is to certify that the said
hereby licensed as provided by law

to sell intoxicating liquors in manner aforesaid at
place of business from the
until midnight on the

Dated this

said

day of

1

day of

1

To the License Commissioners :

We the undersigned do hereby protest against the granting of a license to sell intoxicating liquors as a

to

reasons).

for the following reasons: (Here set forth

Name.

Distance in yards in a direct line
from the proposed licensed
premises.

Date of signing.

I, the undersigned,

do certify that all

persons whose names are appended to the above protest are personally known to me and have signed in my presence and that they are comprised within the twenty nearest householders to the for which

has applied for a license

and the date upon which each person signed the said protest is directly set opposite the name of each person respectively. Dated at in the North-West Territories

this

day of

A.D. 1

A.B.,

Justice of the Peace or Commissioner, etc.

FORM H.

(Section 98.)

FORM OF DECLARATION OF FORFEITURE AND OF ORDER TO DESTROY LIQUOR SEIZED.

If in conviction, after adjudging penalty or imprisonment, proceed thus:

And I declare the said liquor and vessels in which the same is kept to wit: two barrels containing beer, three jars containing whiskey, two bottles containing gin, four kegs containing lager beer and five bottles containing native wine (or as the case may be) to be forfeited to Her Majesty and I do hereby order and direct that T. D., license inspector of the

of

of

said liquor and vessels.

(or J. P. W., license inspector of the ) do forthwith destroy the

Given under my hand and seal the day and year first above mentioned at, etc.

J. P.

If by separate or subsequent order:

Canada,

North-West Territories.

To wit:

I, E. F., one of Her Majesty's justices of the peace in and for the North-West Territories, having on the

of

at the

one thousand of

day

in the said North-West Territories, duly convicted X. Y. of having unlawfully kept liquor without a license, do hereby declare the said liquor and vessels in which the same is kept, to wit: (describe the same as above) to be forfeited to Her Majesty and I do hereby order and direct that J. P. W., license inspector of the of do forthwith destroy the said liquor and vessels. Given nnder my hand and seal this at the

day of

in the said

of

E. F. [L.S.]

complaint was made before the undersigned a justice of the peace in and for the said Territories :

That A.B., there set out the facts as stated in the complaint) and now having duly heard the matter of the said complaint I do order that during the period of one year from the date hereof no licensee after notice of this order shall sell any liquor to the said A.B.

In pursuance of The Liquor License Ordinance you are hereby notified that C.D., of of

in the District labourer (or as the case may be) is interdicted from the use of intoxicating liquors, on order made by G.H., a justice of the peace in and for the North-West Territories, bearing date the day of

and you are required to govern yourself accordingly.

1

You are liable if you give, sell, purchase or procure to, for or on behalf of such prohibited person or for his or her use any liquor, upon conviction, to a penalty of not less than $50 nor more than $200 and in default of payment to not less than two months' nor more than twelve months' imprisonment, and if you are a licensee, forfeiture of license.

Your obedient servant,
E.F.,

Chief Inspector.

FORM L.

(Section 122.)

NOTICE OF INTERDICTION.

Take notice that under the provisions of section 122 of The Liquor License Ordinance I have been required by

(here state name and authority of person who has requested notice to be given) to notify you that you are not to directly or indirectly sell, give or deliver or suffer to be sold, given or delivered to (here insert name and description of person) any intoxicating liquor under a penalty of one hundred dollars and absolute forfeiture of your license. Dated at Regina this

day of

A.D. 1

E.F.,

Inspector.

SCHEDULE 2.

FORMS FOR DESCRIBING OFFENCES.

1. Neglecting to keep license exposed.

That X. Y., having a license for sale by wholesale (or an hotel license) on unlawfully

or wilfully (or negligently) omitted to expose the said license in his warehouse (or in the bar room of his hotel as the case may be.)

unlawfully did keep liquor for the purpose of sale, barter and traffic therein without the license therefor by law required.

4. Sale of liquor on licensed premises during prohibited hours.

at

That X. Y., on in his premises (or on, or out of, or from his premises) being a place where liquor may be sold, unlawfully did sell (or dispose of) liquor during the time prohibited by the The Liquor License Ordinance for the sale of the same, without any requisition for medical purposes, as required by the said Ordinance, being produced by the vendee or his agent.

5. Allowing liquor to be drunk on licensed premises during prohibited hours.

That X. Y., on

his premises, being a place where liquor may be sold by retail (or wholesale) unlawfully did allow (or permit) liquor to be drunk in such place during the time prohibited by The Liquor License Ordinance for the sale of the same by a person other than the licensee or some member of his family or a lodger in his house.

at

6. Sale of less than one quart under wholesale license.

That X. Y., having a wholesale license on

unlawfully did sell liquor in less quantity than one half gallon (or one reputed quart bottle or two reputed pint bottles as the case may be.)

at

7. Allowing liquor to be consumed upon wholesale premises. That X. Y., having a wholesale license on

unlawfully did allow liquor sold by him (or in his possession) and for the sale of which a license is required, to be consumed within his premises (or within the building of which his premises forms part or within a building