FORM D. S. XII

: Bom. XXV] Bombay Prohibition Act, 1949 1 [FORM D. S. XII [See rule 18 (3)] D. S. I Licence No. .............................. Name of the Licensee .............................. Period of the Licence ............................ Register of receipts of rectified spirit under bond at ...................... bonded Warehouse. Advised 1. Form D. S. XII to D. S. XXXV were added by G. N. of 4.11.1968 read with Corrig. of 24.7.1971. 9 10 11 12 13 14 15 16 17 18 Actual quantity received. Temperature Indication Strength Proof litres Allowed Excess Increasein transit Vat to which spirit added and date Remarks, if any, and initials of the Officer in charge of the Warehouse and Licensee Received Loss in transit 1 2 3 4 5 6 7 8 Date of receipt Strength Cask Number Capacity (Actual contents). Temperature Proof litres Number and date of pass Name of Distillery or Warehouse from which received ............... ............... ............... ............... ............... ............... ...............