FORM D.S.XX
[See rule 18(4)]
D. S. I Licence No. ..........................
Name of the Licensee .......................
Period of the Licence...
Monthly return of stock account of denatured spirit for the month of ........................ 20
Bonded warehouse Description of Denatured Spirit.
| On hand and received | Received | Delivered and received | Issued | Deficiencies allowed |
|---|---|---|---|---|
| (This section contains tabular form with columns for stock accounting of denatured spirit; specific column headers and data fields are not clearly legible in the source image.) | ||||
Date. ........................ Signature of licensee ..........................