FORM XI
[See rule 13(3)]
Name of distillery
Month 19 .
Statement showing excess losses in (1) redistillation, (2) transit, (3) reduction, (4) blending, (5) evaporation, (6) racking and (7) others, when the loss at No. (1) exceeds 2per cent, and the losses at Nos. (2) to (7) exceed 0.5per cent, in each case.
| Vat No. (1) |
Date (2) |
Quantity taken up for (3) |
Quantity remaining after the transactions mentioned in coloumn (3) are over (4) Proof litres |
Loss allowed (5) Proof litres |
Excess (6) Proof litres |
Percentage (7) |
Reasons for the excess loss (8) |
|---|---|---|---|---|---|---|---|
| (1) Redistillation .. | .. | Proof litres | |||||
| (2) Transfer .. | |||||||
| (3) Reduction .. | .. | ||||||
| (4) Blending .. | |||||||
| (5) Evaporation .. | .. | ||||||
| (6) Racking | |||||||
| (7) Any other operation .. | .. |
No. dated 19
Submitted to the Industries Commissioner, Maharashtra State, Bombay/ Commissioner of Prohibition and Excise, Maharashtra State, Bombay/Superintendent of Prohibition and Excise/District Inspector of Prohibition and Excise.
Distillery Officer