[S1subrule 3(2), (3)]
Pass for transport of beer/wine as detailed on the reverse (Quadruplicate)
(To be handed over to the licensee for production at the place of destination)
The consignment shall not be broken in transit. This pass shall remain in force upto and including................ 20
Seal
Place:
Date:
Brewery / Manufactory Officer
(Please see the reverse)
Details of the beer / wine allowed to be transported from (here state the name of the Brewery / Manufactory)
Bottle / Casks / Kegs.
| Name of Beer/Wine | Number contained in each | Quantity bulk (ml.) | Total litres | Strength | Remarks |
|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | (6) |
Place:
Date:
Brewery / Manufactory Officer.
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