Statement under Section 11C: mandatory identification, storage and acquisition particulars, signed and filed in duplicate with officer acknowledgement. The statement required under Section 11C must include the declarant's name and full business address, description and location of premises where notified goods are stored, particulars of the notified goods as specified in rule 9, and the date of acquisition together with the name and full address of the transferor. The statement must be signed by the declarant and delivered in duplicate to the proper officer, who will acknowledge the original and retain the duplicate.