25th November. 2004
Notification No. 40/2004-Central Excise (N.T.)
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: |
3. Annual Declaration
(i) New declaration
(ii) Amendments to declaration already filed
(Pl. tick the appropriate box)
4. Declaration for the Financial Year ___________
| Sr. 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
