PART-A CERTFCATON CENTRAL ECSE OFFC

1.Certifid that duty has been paid by debit enty in the Prsonal Ledger Account No. And / or CENVAT
Account Enty No. Or reorded as payale in Daily Stock Account, on the goods described overleaf.
OR
Certifid that the owner has entered into Bond No. Under Rule 19 Central Excise (No.2) Rules 2001 with the
Range :
Division :
Commissionerate :
To
Superintendent of CentraI Excise
(Full Postal Address)
2. / We of
Propose to export the under mentioned consignment to (conuntry of destination) [by Air / Sea/ Land / Post]* under claim for rebate / bond / undertacking*
No.and Date of nvoice under Amount of
Gross Wegiht Mark and Nos. Quantity of Rs. P. Rate % which duty was paid / No. and Reate Claimed
Net Weight on Packages Goods Rs. P date of bond / undertacking exected
under Rule 19
3 4 5 8 10 11 12
3. / We hereby certify that the above mentioned goods have been manufactured.
a) avalilng facility / with out availing facility of CENVET credit under Rules 2002. Rs.
b) avalilng facility / with out availing facility under Notification 21 / 2004 Central Excise (N.T.) dated Rs.
6th September 2004 issued under rule 18 of Central Excise Rule,2002.
C) avalilng facility / with out availing facility under Notification 43 / 2001 Central Excise (N.T.) dated
26th June 2001 issued under rule 19 of Central Excise (No.2) Rule,2001. Rs.
4. / We hereby declare that the export is in discharge of the export oblication under a Quantity based
dvane Licence / under Claim of Duty Drawback under Customs & Centrl Excise Duties Draw
back Rules, 1995.
5. / We hereby declare that the above particulars are ture and corrcetly stated.
*Strike out whichever is not applicable.
Address :
ATTUR RANGE
SALEM - Dt.
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Description of goods
Form A.R.E. 1 (ANNEXURE 1V )
Application for Removal of Excisable Goods Export for by (Air / Sea / Post / Land)
NEAR NEW BUS
STAND, SALEM - Dt.
SALEM - Dt.
1. Particulars of Assistant / Deputy Commisioner of Central Excise / Maritime of Central Excise from whom rebate shall be claimed / with whom bond / under tacking is Executed and his complete postal address
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Time of Removal :
Date :
A. Amount of Bond
B. Amount of Duty involved on goods
cleared for Export Duty not Yet
Exports
7 9
Excise Registration
1
C.Balance as credit as on day
6
Boded No.
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No.and Desciption of
Packages
2
Particulars of manufacturer
of goods and his Central
Duty
Amount