FORM A.R. 3A

Range...............
Division................

Application for removal of excisable goods from a factory or a warehouse
to another warehouse

(Rule 173N)

I/We holder(s) of Central Excise Licence No. ____________ in Form have ______________undertakento remove the undermentioned goods from the factory /warehouse at _________________ to thewarehouse at _________________ in Range ____________________________________ Circle/Division ___________________________of Mr./Messrs ______________________________________________ holderof Central Excise Licence No. ________________________ in Form______________________
+

Number and date of entry in warehouse register	Descriptions of goods	No. and description of packages	Gross weight of packages	Marks and Numbers on packages	Quantity of goods	Date of first warehousing	Value	Duty		No. & date of Gate Pass(es) for removal of goods	Manner of Transport	Remarks
								Rate	Amount
1	2	3	4	5	6	7	8	9	10	11	12	13
							Rs. P	Rs. P	Rs. P

I/We hereby declare the above particulars to be true.


Place ..............
Date ...............

Signature of consignor(s) or his/their authorised agent.

Certificate of rewarehousing by the consignee

(on original and duplicate)

I/We hereby certify that the consignment arrived at ............. on ............. that the goods conform in all respects to the description given overleaf except for the following discrepancies, and that they have been re-warehoused under Entry No. ..............in Part I of our Warehouse register in Fcrm W.R.G.2.

Particulars of discrepancies

No. and description of package not received	Quantity short received	Duty payable on the shortage	Remarks
1	2	3	4

Place .............
Date ..............

Signature of consignee(s) or his/their
authorised agent.

Central Excise Series No.60
Central Excise Series No. 60-A

EXPORT UNDER VBAL/QBAL/OTHERS
A.R. 4 No

Range ...........
Division ........ Address ............
Collectorate ...............

Original (White)
Duplicate (Buff)
Triplicate (Pink)
Quadruplicate (Green)
Quintuplicate (Blue)
Sixtuplicate (Yellow)