Annexure-1A
Form A-2
Application form for central excise
registration of powerloom
weavers / hand processors / Dealers of Yarns
and Fabrics/
manufacturers of ready made Garments*
(*strike
off whichever is not applicable)
1.
Legal Name of the Business with full address of
the premises to be registered …………………..................................
……………………………………………………………………………………………………..................
.............................
2.
Permanent Account Number (PAN) (if given by
Income Tax authorities or else leave blank)……..................................
3.
Name, designation and address of authorised person
(s) ………………………………………….....................................
………………………………………………………………………………………………………...............
............................
4.
Name and address (with telephone nos.) of
Proprietor/ Partner(s)/ Chief Executive Officer / Chairman/ Managing
Director/Trustee/etc
.………………….…………………………………..........................................................................
……………………………………………………………………………………………………..................
.............................
5.
Major excisable goods to be manufactured/traded………………………………………….……........................................
…………..…………………………………………………………………………………………................
.............................
6.
Major raw materials/inputs used in manufacture
of goods mentioned above ……………………....................................
………………………………………………………………………………………………………...............
...........................
7.
Major raw materials/inputs used in manufacture
of goods mentioned above ……………………....................................
………………………………………………………………………………………………………...............
...........................
Declaration
I hereby declare that the information given in this Form is true, correct
and complete in every respect and that I am authorized to sign on behalf of the
Registrant.
[Name and Signature (with date) of the Applicant/authorised person with
stamp]
(in
case of Unregistered Partnership firms all the partners should sign this Form)
…………………………………………………………………………………………………………….…....................................................
Acknowledgement
(to be used if the
Registration Certificate is not given at the time of receipt of the
Application)
In accordance with your application for Registration, the
Registration Certificate will be sent by mail at the address given at Serial
No. 1/handed over personally on …………………at …………..(time).
[Name and Signature (with date) of the Central Excise
Officer with Official Seal].
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