FORM P.L. H
[rule 17(20)]
COUNTERFOIL
(To be kept on licensee's record)
Requisition No................................ of 20
The Manufactory Officer,
Sir;
Please issue.............................. litres of spirit for the manufacture of the following potable liquor:
| Spirit required Month and date | Quantity in litres | Alcoholic proof Strength | Variety of potable liquor to be manufactured | Quantity of each variety of potable liquor to be manufactured in litres | Remark |
|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | (6) |
| ——————————————————————— | (7) |
Signature of licensee or his
Dated: authorised agent.