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Notification No-40/2004-CE(N.T.), Dated 25.11.2004
Rule 9A of the CENVAT Credit Rules, 2004 - FORM ER-5
 

In exercise of the powers conferred by sub-rule (1) of rule 9A of the CENVAT Credit Rules, 2004, the Central Board of Excise and Customs hereby specifies the following Form for the purposes of the said rule, namely, -

 

FORM ER-5
{sub-rule (1) of rule 9A of CENVAT Credit Rules, 2004}


1. Name of the manufacturer:

2. PAN based Registration Number:			ccccccccccccccc

3.  Annual Declaration 

	(i) New declaration

	(ii) Amendments to declaration already filed

	(Pl. tick the appropriate box)

4. Declaration for the Financial Year ___________
S.No Description of principal inputs Central Excise Tariff Sub-HeadingNo. of principal inputs Quantity code* Description of finished goods in which principal input mentioned in column (2) is used Central Excise Tariff Sub-Heading No. of finished goods Quantity code* Quantity of principal input mentioned in column (2) required for use in the manufacture of unit quantity of finished goods mentioned in column (5)
(1) (2) (3) (4) (5) (6) (7) (8)
               

*NOTE. - Please indicate the abbreviation referred to in Instruction No. 7 mentioned in Form E.R.-1 and Form E.R.-3 specified in the Government of India, Ministry of Finance (Department of Revenue) vide No.25/2004-Central Excise (N.T.), dated the 27th September, 2004 published vide G.S.R.No.643 (E) dated the 25th September, 2004.

5. (i) I/We _________________hereby declare that the information given above is true, correct and complete in every respect to the best of my/our knowledge and belief.

(ii) I/We am/are authorized to sign this declaration.
 

(Name in capital letters and signature
of the assessee or authorized signatory)

Place:
Date:

 

ACKNOWLEDGEMENT

Declaration for the Financial Year ___________
 

  D D   M M   Y Y Y Y
Date of receipt                    


Place:
Date:
 

Name and signature of the officer with seal

[F.No. 224/52/2004-CX 6]

 

(Neerav Kumar Mallick)
Under Secretary to the Government of India