[See rule 18]
Part I
(To be sent to the person holding a sale licence or to the Warehouse Officer or Distillery Officer from whom the rectified spirit is to be purchased)
Place ..............................
Date ..............................................
Messrs ............................................ ......................................
The Warehouse — Officer,
Distillery
Sir(s),
Please supply me/us with 1litres/bottles of * millilitres each1 of rectified spirit/ absolute alcohol for 1sale licence1 purposes.
The number of my rectified spirit 1possession licence/bottling licence1 issued by the Collector of ........................... is ...................................
Yours faithfully,
Signature of the purchaser.
Countersigned.
Inspector of Prohibition and Excise Date. .............................. No ................................
Seal of the Officer Countersigning the requisition.
Part II
Rectified spirit/absolute alcohol supplied on ....................................
Quantity supplied ....................................
Signature of the person holding a sale licence or of The Warehouse officer, Distillery ........................................................
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