Form I - [see rule 4(1) and (3)] - Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable and Other Goods) Rules, 2016

Form I [see rule 4(1) and (3)] Information under Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable and Other Goods) Rules, 2016 To, The Assistant Commissioner or Deputy Commissioner of Central Excise, Division .......... , Sir, We intend to avail benefit of exemption of duty for the purpose of manufacture of goods in our factory. The details of the goods proposed to be procured, quantity, duty foregone, S.No of the notification under which exemption is intended to be availed, approximate quantity needed, details of the supplier manufacturer from whom the goods are proposed to be procured and finished goods proposed to be manufactured are enclosed herewith. We undertake to follow the Central Excise (Removal of Goods at Concessional Rate of Duty for Manufacture of Excisable and Other Goods) Rules, 2016, as required and use the subject goods in terms of the conditions specified in the said rules. (2) We undertake to pay on demand, in the event of failure to comply with conditions, an amount equal to the difference between the duty leviable on such quantity of the subject goods but for the exemption under the aforesaid rules and that already paid at the time of removal, with interest and penalty as demanded. We have executed the necessary letter of undertaking or bond with surety. Date : Place : Signature and stamp of authorised signatory, with name and address of the premise , (Registration Number) (Suitably amend for multiple supplier manufacturer)