Annexure - QUARTERLY RETURN See rule 7(c) - Customs (Import of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 1996

Annexure QUARTERLY RETURN Return for the quarter ending [See rule 7(c)] Name of the imported goods: S.No BE No and date Description of goods imported at concessional rate Details of goods imported during the quarter Specified purpose for procuring the goods at concessional rate of duty Goods manufactured during the quarter Whether the goods used for specified purpose or not. In case of export, specify the quantity exported with details of ARE-1/ ARE-2. Opening balance On the 1st day of the quarter Value of goods received during the quarter Quantity of goods received during the quarter Total of Col. (4) and (6) Quantity consumed for the intended purpose, during the quarter Quantity re-exported during the quarter Closing balance on the last day of the quarter Description Quantity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (Note: Separate entries should be made for each variety or class of imported goods used and goods manufactured.) Declaration I/We hereby declare that the undersigned have compared the above particulars with the records and books maintained by my / our factory and that they are true and correct in every respect and are in accordance with the Customs (Import of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Rules, 1996. Date: Place Signature and name of the authorized person of the manufacturer. Seal of the company --------------------------------------- Notes:- 1. Inserted vide Notification No. 160/2009-Cus(NT), dated 30/10/2009 Further Substituted vide Notification No. 22/2012-Cus(NT), dated 17/03/2012 before it was read as:- "Annexure" MONTHLY RETURN Return for the month of [see Rule 7(c)] Name of the imported goods: Sl. No. Description of goods imported at concessional rate Details of goods imported during the month Goods manufactured during the month Specified purpose for procuring the goods at concessional rate of duty Whether the goods used for specified purpose or not. In case of export, specify the quantity exported with details of ARE-1/ ARE-2. Opening balance On the 1 st day of the months Received during the month Total of Col.(3) (4) Quantity consumed for the intended purpose, during the month Closing balance on the last day of the month Nature Quantity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) ( Note: Separate entries should be made for each variety or class of imported goods used and goods manufactured.) Declaration I/We hereby declare that the undersigned have compared the above particulars with the records and books maintained by my / our factory and that they are true and correct in every respect and are in accordance with the Customs (Import of Goods at Concessional Rate of Duty for Manufacture of Excisable Goods) Amendment Rules, 2009. Date: Place: Signature and name of the authorised person of the manufacturer. Seal of the company"