FORM CERTIFICATE 2

FORM “ CERTIFICATE-2” [See rule 11(3)] No. ....................................... Dated ................................... Certified that Mr./Mrs./Miss./Messers ......................................... of .................................................. who has/have been granted an import pass No. .............................................................. dated, ...................................................... by ........................................................... has/have been issued Indian made foreign liquor from the Distillery/Brewery/Bonded Warehouse at ............................................................... in the district of...................................................... as shown below : ————————————————————————————————————— Description of Indian Number and descrip- Marks and Capacity of each made foreign liquor (1) tion of each kind of receptacle (2) Numbers on packages or (3) receptacle or package (4) ————————————————————————————————————— ————————————————————————————————————— ————————————————————————————————————— Actual contents Litres Thermometer Indication Hydrometer Indication Strength Proof litres (5) (6) (7) (8) (9) ————————————————————————————————————— ————————————————————————————————————— and that the receptlacle and packages containing the said Indian made foreign liquor are securely packed in my presence and sealed with my official seal. Place : Signature and designation of the Excise Officer at the exporting place.