Application for permit to receive and use, or receive and on-supply, or import duty free alcohol Specify type of permit required: [




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Form NZCS 240 | SEC 83 | june 2011




Application for permit to receive and use, or receive and on-supply, or import duty free alcohol

Specify type of permit required: [  ]

 (a) Permit to receive and use duty free undenatured ethyl alcohol of an alcoholic strength by volume of 80% Vol. or higher.

 (b) Permit to receive and use duty free alcoholic beverages for use in the manufacture of approved products.

 (c) Permit to claim concession on imported undenatured ethyl alcohol of an alcoholic strength by volume of 80% Vol. or higher.

 (d) Permit to receive and on – supply duty free undenatured ethyl alcohol of an alcoholic strength by volume of 80% Vol. or higher from Customs Controlled Areas.

Applicants name: ..

Organisation: ..

Address of principal place of business: ..

NB: Storage, handling, packaging & transportation of ethyl alcohol (ethanol) must be in accordance with OSH & Dept of Labour requirements

I hereby apply for a permit to receive/import ..…………………. litres per year of duty free alcohol viz:

..…………………………………………………………………………. to be used exclusively for the following purpose:

(state type of alcohol e.g. ethanol, rum etc)

..


..

..


If using ethyl alcohol (ethanol); I cannot use denatured ethanol or any other alternative for the following reasons:

..


..

..


Any waste or residual ethyl alcohol remaining after the permitted use will be dealt with in the following manner: ..

..


..

I agree to comply with the conditions and general responsibilities specified on any permit issued and I understand any permit so issued may be revoked if the conditions and responsibilities are not complied with.

Signature of applicant: .. Date: ..

Position within organisation: ..

Contact telephone: .. Email: ..

Contact fax: ..






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