Annexure I - Annexure I - Application under Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 2001 - Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 2001

Annexure I Application under Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 2001 (Original with 3 copies to be submitted through the Range Superintendent) To, The Assistant Commissioner or Deputy Commissioner of Central Excise, Division ………………………. Vide S. No ……………….. of Notification No……………… Central Excise, dated the…………….. issued under Section 5A (1) of the Central Excise Act, 1944 read with the relevant provisions of the Central Excise Act, 1944 (1 of 1944) and the Central Excise Tariff Act, 1985 (5 of 1986) and other laws for the time being in force the goods, namely,………………. used for the specified purpose of…………… attract the following excise duty (ies) (specify rates): Basic excise duty /Special excise duty /Additional duty(ies) /Other Duty(ies). We undertake to follow the Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 2001 as required by the above notification. The quantity and value of subject goods, we wish to obtain during the financial year for the aforesaid specified purpose is (specify quantity and value) and we intend to procure the subject goods for use in our premises at. ………………….. The estimated duty leviable on the subject goods but for the exemption under the above notification is rupees………………... only (attach calculation sheet) and the estimated total duty on the subject goods payable at the time of removal under the above notification is rupees……………... only (attach calculation sheet). We also hereby undertake: (a) to use the subject goods………………… for the purpose of………………. and to follow any other condition that the said notification imposes on us; and (b) to pay on demand, in the event of failure to comply with (a) above, an amount equal to the difference between the duty leviable on such quantity of the subject goods but for the exemption under the aforesaid notification and that paid at the time of removal. We have also executed the necessary bond dated………… (enclose the bond executed) for your acceptance. Date Place Signature and stamp of authorised signatory, with name and address of the premise (Endorsement and counter-signature of the said Assistant Commissioner or Deputy Commissioner on the application) It is hereby certified that M/s having their premise at.......Have executed the bond as required by the said rules, for rupees….....only, which has been accepted on behalf of the President of India by the undersigned and entered at S. No. dated ………………… of Bond Register. F.No. Signature of the said Assistant Commissioner or Deputy Commissioner with date, name, stamp and seal Date Place