(See rule 18)
Requisition for rectified spirit or absolute alcohol
Part IV
(To be sent to the Inspector of Prohibition and Excise in whose charge the licensed premises of a person holding a sale licence, warehouse or distillery is situated.
Place.
Date.
Mesa
— Warehouse —
The————————————— Officer,
Distillery
Sir(s),
Please supply me/us with litres/bottles of millilitres each] of rectified spirit / absolute alcohol for Purposes.
e . sale licence . ..
The number or my rectified spirit————————————————————— issued by
1[possession licence/bottling licence.]1
the Collector of.
Yours faithfully,
Signature of the purchaser
Countersigned.
Inspector of Prohibition and Excise Date No
Seal of the
Officer
Countersigning
The requisition.
Verified from the register of the supplying Licensee or the Warehouse/Distillery
Officer on
Intimation of the supply sent to the Prohibition and Excise Officer countersigning the requisition on .
Signature of the Inspector of
Prohibition and Excise.
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