ANNEXURE-A
Original/Duplicate/Triplicate/Quadruplicate
Range .....Division ..
Application for removal of excisable goods from a factory or a warehouse to another warehouse
I/We holder(s) of Central Excise Registration No have undertaken to remove the under-mentioned goods from the factory/warehouse at .to the warehouse at . ..in Range .Division ..of Mr./Messrs . holders of Central Excise Registration No .. .
|
|
Description
of goods |
No.
and description of packages |
Gross
weight of packages |
Marks
and numbers on packages |
Quantity
of goods |
Date of first ware- housing
|
Value
|
Duty
Rate
Amount |
No.
& date of invoice- (s) for removal of goods |
Manner
of transport |
Remarks
|
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
10 |
11
|
12
|
13
|
|
|
|
|
|
|
|
|
Rs.
P. |
Rs.P Rs. P.
|
|
|
|
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I /We hereby declare the above particulars to be true.
Place ..
Date Signature of consignor(s) or his/their authorized agent.
Certificate of warehousing by the consignee
(on original and duplicate)
I/We hereby certify that the consignment arrived at . .on ...that the goods conform in all respects to the description given overleaf except for the following discrepancies, and that they have been warehoused under Entry No .of the register maintained in the ware house.
Particulars of discrepancies
|
No. and description of packages not received. |
Quantity short received |
Duty payable on the shortage |
Remarks |
|
1 |
2 |
3 |
4 |
|
|
|
|
|
Place ..
Date .. Signature of consignee(s) or his/their authorized agent.