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shall state the kind and quantity of wine or alcohol required, and the purpose for which it is to be used, and the full and true name and address as aforesaid, of the purchaser, and likewise the place where the wine or alcohol is to be kept and, used, and that he solemnly certifies upon his honor and under penalty of the law that he will not use or suffer any other person to use, such wine or alcohol for any other purpose than the one specified in the application, and will keep the liquor at the place designated until used. Such application shall be cancelled,

filed and kept as aforesaid, and shall be substantially in the following form:

PURCHASER's APPLICATION To DRUGGIST.

- - - - - - - - - - - - - - - - - - - - - - (Name of Druggist): I do hereby solemnly certify upon my honor and under penalty of

the law that my full and true name is

- - - - - - - - - - - - - - - - - - - - - - - - - - - that I reside at . . . . . . . . . . . . . . . . . . . . . . . . . (house number and street) on the . . . . . . . . . . . . . . . . . . . . . . (city or village) of . . . . . . . . . . . . . . . . . in the county of. . . . . . . . . . . . . . . . . . , Illinois; that I have never been

convicted of any violation of the law entitled: “An Act to restrict the manufacture, possession and use of intoxicating liquor within prohibi

tion territory”; that I require. . . . . . . . . . . . . . - - - - - - - - - (quantity) of * * * * - - - - - - - - - - - - (wine or alcohol) to be used for . . . . . . . . . . . . . . . . . . (sacramental, mechanical, chemical or manufacturing) purposes at * * * * - - - - - - - - - - - - - - (house number and street) in the . . . . . . . . . . . . . . (city or village) of . . . . . . . . . . . . . . . . . in the county of . . . . . . . . - - - - - Illinois; that I will not use or suffer any other person to use such * * * - - - - - - - - - - - - (wine or alcohol) for any other purpose than the one

above specified and will keep the . . . . . . . . . . . (wine or alcohol) at the Place designated until used. (Signature of Purchaser)

§ 10. Any druggist who shall, by himself or another, within prohibition territory, sell, give away, or in any manner dispose of any intoxicating liquor, or in any manner aid any person in procuring any intoxicating liquor, in any quantity whatsoever, without strictly complying with sections two (2) and nine (9) of this Act shall, for each offense, be fined not less than two hundred dollars ($200) nor more than four hundred dollars ($400) or imprisoned in the county jail for not less than ten (10) days nor more than thirty (30) days or both. in the discretion of the court; and it shall be unlawful for him, either with or without a permit, to receive or keep any intoxicating liquor within prohibition territory for the period of two (2) years after such first conviction. The court in which such conviction is had shall send notice to the Attorney General, upon receipt whereof the permit provided for in section two (2) shall be forthwith revoked for the period of two (2) years after such conviction. If any druggist shall be convicted of violating any provision of this section, and shall subsequently violate any provision of this section, he shall, upon conviction thereof, for each offense, be fined not less than four hundred dour- $4") nor more than eight hundred dollars ($800), and be imprisoned in the county jail not less than ninety (90) days nor more than one (1) year, in the disoretion of the court; and it shall be unlawful for him, either with or Without a permit to receive or keep any intoxicating liquor within prohibition territory for the period of five (5) years after such second conviction; and if he be a registered pharmacist, local registered pharmacist, or registered assistant pharmacist, it shall be part of the judgmel: upon such second conviction that his certificate to practice pharmacy shall be forthwith revoked, and the court before which such convictiol. is had shall so order and forthwith cause a copy of such order to be sent to the Director of Registration and Education, upon receipt wherec: such certificate shall be forthwith revoked by the Department of Registration and Education and shall not be renewed for the period of two (2) years after such revocation, and the court shall further send notic to the Attorney General, of such conviction, and upon receipt whereof the permit provided for in section two (2) shall be forthwith revoked for the period of five (5) years after such conviction. A certified transcript of the judgment of such conviction shall be sufficient evidence of such conviction to such Department of Registration and Education and Attorney General. And in like manner if he shall subsequently violate any provision of this section, for such third violation he shall, for each offense, be fined not less than five hundred dollars ($500) nor more than one thousand dollars ($1,000), and be imprisoned in the pententiary for not less than one (1) year nor more than three (3) years, and if he be a registered pharmacist, local registered pharmacist, or registered assistant pharmacist, it shall be part of the judgment upon such third or any subsequent conviction, that his certificate to practice pharmacy shall be forthwith revoked as aforesaid, and he shall forever thereafter be barred from practicing pharmacy in this State, or holding any permit to manufacture, sell or keep for sale, intoxicating liquor. § 11. Any registered pharmacist, local registered pharmacist or registered assistant pharmacist who shall sell, give away, or in any manner dispose of any intoxicating liquor, or in any manner aid any person in procuring any intoxicating liquor in any quantity whatsoever, within prohibition territory, without strictly complying with sections two (2) and nine (9) of this Act, shall for each offense, be fined not less than one hundred dollars ($100) nor more than four hundred dol. lars ($400), or be imprisoned in the county jail for not less than thirty (30) days nor more than ninety (90) days or both, in the discre. tion of the court. If any such pharmacist shall be convicted of violatinany provisions of this section and shall subsequently violate any provision of this section, he shall for each offense, be fined not less than two hundred dollars ($200) nor more than eight hundred dollars ($800) and be imprisoned in the county jail for not less than ninet, (90) days nor more than one (1) year, in the discretion of the court: and it shall be part of the judgment upon such second conviction, that his certificate to practice pharmacy shall be forthwith revoked, and to court before whom such conviction is had shall so order and forthwo cause a copy of such order to be sent to the Director of Registration ar:

*ation, upon receipt whereof such certificate shall be forthwith re*d by the Department of Registration and Education, and shall not to renewed for the period of two (2) years after such revocation, and the Court shall further send notice of such conviction to the Attorney "eneral, upon receipt whereof the permit provided for in section two (*) shall be forthwith revoked for the period of two (2) years after such conviction. A certified transcript of the judgment of such conViction shall be sufficient evidence of such conviction to such Department of Education and Registration, and Attorney General. And in like manner, if he shall subsequently violate any provision of this section, for such third violation he shall, for each offense, be fined not less than five hundred dollars ($500) nor more than one thousand dollars ($1,000), and be imprisoned in the penitentiary for not less than one (1) year nor more than three (3) years, and it shall be part of the Judgment upon such third conviction that his certificate to practice pharmacy shall be forthwith revoked as aforesaid, and he shall forever thereafter be barred from practicing pharmacy in this State, and of o any permit to muanafcture, sell or keep for sale, intoxicating lquor. § 12. Any physician who shall write a prescription for intoxiCating liquor without having first personally examined the person for whom the prescription is written, and without having ascertained that such person requires such liquor for medicinal use, or who shall make a false statement in any prescription, or write a prescription to enable *ny person to procure any intoxicating liquor, or in any manner procure or aid in procuring any intoxicating liquor, for any person within prohibition territory, except to be used in the treatment of a bona fide case of sickness, shall, for each offense, be fined not less than two hundred dollars ($200) nor more than five hundred dollars ($500) or be Imprisoned in the county jail for not less than sixty (60) days nor more than six (6) months or both, in the discretion of the court. If any physician shall be convicted of violating any provision of this section and shall subsequently violate any provision of this section, he shal), for each offense, be fined not less than five hundred dollars ($500) nor more than one thousand dollars ($1,000) and be imWilsoned in the county jail for not less than six (6) months nor more than one (1) year, in the discretion of the court; and it shall be Part of the judgment upon such second conviction that his license to Practice medicine shall be forthwith revoked, and the court before whom such conviction is had shall so order and forthwith cause a copy "f such order to be sent to the Director of Registration and Education, Upon receipt whereof his license to practice medicine shall be forthwith revoked by such Department and shall not be renewed for the period of two (2) years after such revocation. A certified transcript of the \gment of such conviction shall be sufficient evidence of such conViction to such Department. And in like manner, if he shall subse\oy violate any provision of this section, he shall, for each offense, fined not less than five hundred dollars ($500) nor more than one Wand dollars ($1,000) and be imprisoned in the penitentiary for not less than one (1) year nor more than three (3) years; an it shall be part of the judgment upon such third conviction that he license to practice medicine shall be forthwith revoked as aforesaid, and he shall forever thereafter be barred from practicing medicine in the State. § 13. Any consignee, purchaser, or person to whom any intoxicating liquor shall be delivered, under the provisions of this Act, who shall use any intoxicating liquor received from any carrier or druggs for any other purpose than the one stated in such carrier’s or druggist's record, or suffer any other person to do so, or who shall fail or negle: to keep such liquor in the original labeled vessel and at the place designated, until used, shall be punished in the manner prescribed II section eight (8) of this Act. Provided, the sheriff of the county may, in his discretion, grant a written permit to remove such liquor to another designated place. § 14. Whoever shall forge the signature of any consignee or sign a fictitious name, or the name of any other person to any druggist's record or to any purchaser's application to a druggist, or forge the signature of any physician to any supposed prescription for intoxicating liquor, or having been convicted of a violation of any provision of this Act, shall sign a statement to any carrier or druggist in order to receive intoxicating liquor from such carrier or druggist under the provisions of this Act, or shall wilfully alter, add to, deface, or destroy any carrier's or druggist’s record, consignee's statement to carrier, application to a druggist, prescription for intoxicating liquor, or label upon any vessel or package of intoxicating liquor, or shall feloniously stea or cancel any carrier's or druggist's record, consignee's statement to carrier, purchaser's application to a druggist, or prescription for intoxicating liquor, required to be kept under the provision of this Act, shall. on conviction thereof, be imprisoned in the penitentiary for not less than one (1) year nor more than three (3) years. § 15. All places within prohibition territory where any intoxicating liquor is manufactured, kept for sale, used or in any manner dis. posed of in violation of any provision of this Act, shall be taken and held and are hereby declared to be common nuisances, and may be abated as such ; and whoever shall keep any such place by himself of his agent or servant, shall, upon conviction thereof, be fined not less than two hundred dollars ($200) nor more than five hundred dollars ($500) or confined in the county jail for not less than thirty (30) days nor more than six (6) months, or both, in the discretion of the court. and it shall be part of the judgment, upon conviction of the keeper, that the place so kept shall be shut up and abated until the keeper shall give bond with sufficient surety to be approved by the court in the penal sum of five thousand dollars ($5,000), payable to the People of the State of Illinois, conditioned that he will not violate any of the provisions of this Act, and in case of a violation of the condition of such bond, suit may be brought and recovery had thereon for the amount of said bond for the use of the county. § 16. All intoxicating liquor manufactured, kept for sale, used. disposed of, or transported within prohibition territory, in violation of

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my law of this State, with all vessels containing the same, and all implements, furniture and vehicles kept or used for any such purposes, are hereby declared to be common nuisances, and shall be subjected to seizure, confiscation and destruction in the manner hereinafter provided: Whenever complaint is made in writing, verified by affidavit, to any judge having cognizance of criminal offenses within such prohibition territory, that complainant has just and reasonable grounds to believe and does believe that intoxicating liquor is manufactured, kept for sale, used, disposed of, or transported in violation of any law of this State in any house, building, premises, boat, vehicle, receptacle or any other place whatsoever (particularly describing and designating the same) in prohibition territory, with the facts upon which such belief is based, the judge may issue a search warrant as hereinafter provided. Protided however, no warrant shall be issued to search a private dwelling occupied as such unless such warrant is signed by two judges, and unless such residence is a place of public resort, or intoxicating liquor is sold or kept for sale in violation of the law. Each complaint may be substantially in the following form: STATE of ILLINois, |. Cot NTY of... . . . . . J

CoMPLAINT FOR SEARCH WARRANT.

THE COMPLAINT AND AFFIDAVIT of . . . . . . . . . . . . . . . . . . . . (name of complainant) of . . . . . . . . . (his residence) made before. . . . . . . . . . . . (name of officer) one of the . . . . . . . . . . . . . . . . . (official title of officer) in and for said. . . . . . . . . . . (county, city or village, as the case may be) on this, the . . . . . . . . . day of . . . . . . . . . . . . . . . , 19. ..., who, being first duly sworn, upon his oath says; that he has just and reasonable grounds to believe and does believe that intoxicating liquor is now unlawfully * * * * - - - - - - - - (manufactured, kept for sale, used, disposed of, or transported as the case may be) within prohibition territory, to-wit: At and within a certain. . . . . . . . . . . . . (here describe the house, building, premises, boat, vehicle, receptacle, or other place, to be searched, with particulars as to its location sufficiently to identify it, stating the name of the person occupying the same, if known) in the . . . . . . . . . . . . (city, village or town) of . . . . . . . . . . . . . . . . . . . . . . . . in the county and State aforesaid; and that the following are the reasons for his belief, to-wit: * * - - - - - - - - - - - - (here insert the facts upon which such belief is based).

WHEREFORE, he prays that a search warrant may issue according to law.

(Signature of Complainant) SUBscRIBED AND Swor N To before me this. . . . . . . . . . . . . . . . day of

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

(Official title of officer)

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