APPLICATION FOR CENTRAL EXCISE REGISTRATION [see rule 9 of Central Excise Rules, 2002]

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....PAN has been issued by the Income Tax Department Yes No (ii) If Yes, the PAN (iii) Name of the Registrant (as appearing in PAN) (iv) If PAN is not available, whether applied for PAN Yes No 3. Category (tick only one box) Manufacturer Warehouse Export Oriented Unit Unit within Export Processing Zone Manufacturer's Depot Dealer 1[Importer] 4. Constitution of business (tick only one box) (Please see instruction No. 7) Proprietorship Partnership Registered Company Unregistered Company Trust Society Others 5. Address of business premises (i) Name of Premises/Building (ii) Flat/Door/Block No. (iii) Road/Street/Lane (iv) Village/Area/Locality (v) Block/Taluk/Sub-Division/ Town ....

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....o. 8) (a) Office (b) Residence (xiii) Fax No. (Please see instruction No. 8) (xiv) E-mail Address 11 Details of Bank Accounts used for business transactions by the Registrant (Please see instruction No. 11) (a) Number of Bank Accounts (b) Account 1 (i) Name of the Bank (ii) Name of the Branch (iii) Account No. (c) Account 2 (i) Name of the Bank (ii) Name of the Branch (iii) Account No. Part II: Business Transaction Number obtained from other Government Agencies/Departments 12 Details of Business Transaction Numbers obtained from other Government Agencies/Departments (i) Customs Registration No. (BIN No.) Yes No If yes, give details (ii) Directorate General Foreign Trade's Import Exp....

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....behalf of the Registrant. (Please tick appropriate box) (a) For new Registration/Amendment to Registration Certificate I would like to receive the Registration Certificate by mail at the address specified at S. No. ______ of Part-I by Hand (b) For amendments to information pertaining to existing Registrant The above mentioned amendments are with effect from / / Date: (Signature of the applicant/authorised person with stamp) Place: (Please see instruction No. 16) ACKNOWLEDGEMENT (To be given in the event Registration Certificate is not issued at the time of receipt of Application for Registration) I hereby acknowledge the receipt of your Application Form (a) For new Registration / amendments to....

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....lank. Also one box may be left empty after completion of each entry. For example more than one telephone number may be given as under: 0 1 1 3 0 9 2 8 2 9 0 1 1 3 0 9 2 8 3 0 5) The name should be the name and style in which the Registrant is likely to carry out business from the premises seeking to be registered. Please do not mention any prefixes such as M/s, Mr., Shri, etc. In case of a proprietary concern or a business owned by Hindu Undivided Family, the name of the proprietor or Hindu Undivided Family, as the case may be, shall be indicated at serial number 13 (see instruction no.14). 6) An attested copy of PAN allotted by the Income Tax Department should be enclosed; in case PAN has not been allotted attested copy of the ....