FORM BRQ
[See rule 8 (5)]
COUNTERFOIL
(To be kept on licensee's record)
Requisition for issue of spirit from the spirit room for the fortification of wine.
Requisition No. ________ of 19________
The Manufactory Officer,
Please issue ________ litres of *rectified spirit/*absolute alcohol/*brandy for the fortification of wine.
| (1) Month and date | (2) Quantity in litres | (3) Strength Proof | (4) Alcoholic content | (5) Variety of wine to be fortified | (6) Quantity of each Variety of wine to be fortified | (7) Remarks |
|---|---|---|---|---|---|---|
| Litres ________ Litres ________ | ||||||
*Retain which is required.
Signature of licensee or his authorised agent
Dated: ________
Seal
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