FORM C.L.W Vai—Contd.
Supplied to retail sale shop licensees during the month and wastage, if any
| 75° ml. Bottles B.L. (20) | 375 ml. B.L. (21) | 180 ml. B.L. (22) | Quantity in B.L. (23) | 200 B.L. (24) | B.L. (25) |
|---|---|---|---|---|---|
Held in balance at the close of the last day of the month supplied to retail licensees during the month and wastage, if any
| Quantity in receptacles B.U (26) | Total (23+26) (27) | Wastage, if any, with reasons B.L. (28) | 750 ml. B.L. (29) | 375 ml. B.L. (30) | 180 ml. (31) |
|---|---|---|---|---|---|
Held in balance at the close of the last day of the month
| Quantity in Bottles B.L. (32) | 200 B.L. B.L. (33) | Quantity in receptacles B.L. (34) | Total B.L. (32+35) (35) | Remarks, if any (37) |
|---|---|---|---|---|
* Here mention the receptacles of any other capacity allowed to be filled in by the Commissioner.
No ........................... Dated ............................
Submitted for favour of information to
- The Commissioner of Prohibition and Excise, Maharashtra State, Bombay.
- The Superintendent of Prohibition and Excise.
Signature of the licensee or his authorised agent.