(Reverse)
Details of the liquor allowed to be transported from (here state the name of the Manufactory)
| Variety of liquor | Bottles Number contained in each (bottle) | Quantity litres | Total litres | Strength | Proof | Remarks |
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Manufactory Officer.
Place: _________________ Date: _________________
(Reverse)
Details of the liquor allowed to be transported from (here state the name of the Manufactory)
| Variety of liquor | Bottles Number contained in each (bottle) | Quantity litres | Total litres | Strength | Proof | Remarks |
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Manufactory Officer.
Place: _________________ Date: _________________
Y-373-86
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