FORM BRIND
[See rule 8 (2)]
Counterfoil
(For licensee's record)
Indent for spirit for the fortification of wine
Name of Manufactory:
Indent No. _____ of 19 _____.
Messrs
Gentlemen,
Please issue _____ litres of *rectified spirit/*absolute alcohol/*brandy for the fortification of wine, in my/our manufactory.
Signature of licensee or his authorised agent
Licence No.
Countersignature of Manufactory Officer.
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