FORM C.I.VI.D
[See rule 6(18)]
Counterfoil
(To be kept on licensee's record)
Requisition for issue of spirit from the spirit room for the manufacture of Country Liquor
Requisition No................................. of 20
The Manufactory Officer,
Sir,
Please issue _______ litres of spirit for manufacture of the following Country Liquor:—
| Spirit Required | Month and date | ||||
|---|---|---|---|---|---|
| Quantity in bulk litres (1) |
Strength (in Proof litres) (2) |
Alcoholic content (3) |
Variety of country Liquor to be manufactured (4) |
Remarks (5) |
|
Signature of licensee or his authorised agent
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