Serial Number______/___-___ (Financial Year).

Range

Division

Commissionerate

FORM CT-1

Certificate for procurement of excisable goods for export without

payment of duty

This is to certify that,

(1)    The exporter has furnished a Bond in Form [Specific/General]* for Rs___________________, which has been accepted by the Assistant Commissioner of Central Excise/the Deputy Commissioner of Central Excise in F.No. _______________________ on the _________day of the ___________(month) ___________ (Year).

OR

Mr./Messers. ______________________________(Name and address) is/are registered under rule 9 of Central Excise (No.2) Rules, 2001 in this Range, having registration number__________________________________has furnished an undertaking in the form specified under Notification No. /2001-Central Excise (N.T.) dated to the Assistant Commissioner of Central Excise/the Deputy Commissioner of Central Excise, _____________________(Name of the Division or the Office) who has accepted the undertaking in F.No. _______________________ on the _________day of the ___________(month) ___________ (Year).

(2)    The above-said exporter/manufacturer-exporter is permitted to obtain excisable goods for export under rule 19 of the Central Excise (No.2) Rules, 2001 as per details specified overleaf. This certificate is valid upto one year from the date of issue specified below.

Name and Signature of the

Superintendent of Central Excise

["Seal"]

Dated:

(Address of the RangeOffice)