Central Excise Series No. 57-A
FORM A.R.I-A
Application for removal of excisable goods from a Free Trade Zone or from
a hundred per cent export oriented undertaking] on payment of duty
(Rule 100D)
Name and address of owner /manufacturer.................. Range.......................L4Licence number, if applicable........................... Division....................Name of the buyer andaddress................................. Collectorate................ Free Trade Zone if applicable..................
| No. & Date ofentry in the register | No. & descriptions of package | Gross weight of package | Marks & Nos. | Weight or Quantity | Description of goods. Classification as per the First Schedule to the Customs Tariff Act, 1975 (51 of 1975). Classification as per the Schedule to the Central Excise Tariff Act, 1985 (5 of 1986), for the purpose of additional duty (Customs) | Invoice | Assessable value for column 9 |
Excise Duty
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| Per unit | Total | Equal to Basic Customs duty | Equal to Auxiliary duty | Equal to any others Customs duty |
| Rate | Amount | Rate | Amount | Rate | Amount |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8(a) | 8(b) | 9(a) | 9(b) | 9(c) | 9(d) | 9(e) | 9(f) |
| Assessable value for Column 11 | Excise Duty equal to Additional [(Customs) Duty] | Total of Column 9 and 11 | Serial No. of Gate Pass issued | Remarks |
| Basic Excise Duty | Special Excise Duty | Additional Excise Duty | Cess | Any other duty of Excise |
| Per Unit | Total | Rate | Amount | Rate | Amount | Rate | Amount | Rate | Amount | Rate | Amount |
| 10(a) | 10(b) | 11(a) | 11(b) | 11(c) | 11(d) | 11(e) | 11(f) | 11(g) | 11(h) | 11(i) | 11(j) | 12 | 13 | 14 |
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____________________________________________Total amount of duty For payment through Account No. and entry(in words Rupees .......... Amount Account Current No.______________________________ ____________________________________________(By pinpoint typewriter) Declaration Total ................. I/ We declare the above particulars to be true and Authorisation Permit No. correctly stated. and Date .............. I/ We apply for leave to clear to above goods. Place ................. Signature of Assessing Officer Signature of the Date .................. ___________________________________ owner/ manufacturer. Counter-signature of Assistant CollectorClearance allowed............Time.........................G.P.1-A No. .................Date......................... Place ................. Signature of Central Excise Office. Date ..................