FORM D. S. XVIII

: Bom. XXV] Bombay Prohibition Act, 1949 FORM D. S. XVIII [See rule 18 (3)] D. S. I Licence No. .............................. Name of the Licensee............................ Period of the Licence ............................ Register of issues of denatured spirit to shops or manufactactories for bonded Warehouse Description of denatured Spirit Date of presentation of Serial Number Number of pass Date of pass Place at which the requisition of Bonded shop is situated Warehouse (1) (2) (3) (4) (5) Licensed shop to Spirit actually Route to be which the spirit is to Number of Registered contained in Temperature taken be transferred each cask capacity of each each ca sk cask (6) (7) (8) (9) (10) (11) Indication Strength Proof litres Vat from Date and hour Remarks, if any, and Bulk litres which drawn when the spirit was initials the officer-in- issued charge of the warehouse and licensee (12) (13) (14 (15) (16) (17)