Application for refund of excise duty

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....We enclose the following documents in support of the claim. 1. 2. 3. 4. 5. 3. The amount claimed was originally paid by AR1/AR5/ AR6/ AR7/AR8/AR9/ AR10/ DD1/ DD2 Treasury Challan No. __________ dated _____________deposited into ______ Treasury under the Head of Account III-Union Excise duties/Duty on __________ miscellaneous receipts/by adjustment in account current No. _______ dated __....

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....ed. 8. I/We undertake to refund on demand being made within six months of the date of payment of any rebate erroneously paid to me/us. 9. I/We declare that the goods received by me/us after payment of Central Excise duty for which refund has been claimed has been consumed by me/us as industrial consumer/has been sold in wholesale/retail. Dated_______________     &e....

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...._____ dated _________ for Rs. _____________ (Rupees _________________) issued on _____________ (RBI/SBI/Treasury) in settlement of this claim. ________________________________________________________________________________________________________________________ AC of Central Excise_______________ (For use in the CA.O.'s office) Post audited certified that (i) the amount concerning which ....