Monthly return for payment of Health Security se National Security Cess

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....cified goods (e.g., Pan Masala) as declared in Form HSNS DEC-I. Table Sl. No. Machine Registration No. [A dropdown box containing registered No. of machines will be shown in the rows] Machine Status Applicable Monthly Cess Rate (As per Schedule II) (Rs.) Total Cess Payable (Rs.) Working Status for the Month (Yes/No) Date of Sealing [DD/MM/YYYY] Date of Desealing [DD/MM/YYYY] (1) (2) (3) (4) (5) (6) (7)                             ...             Total         (A) 3. Details of cess payable for the month (Wholly manual pro....

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....ction 17 of the Act) (E)   6. Penalty (if applicable) (F)   7. Total Amount payable (G=D+E+F)   6. Cess payment details as per Table below: Table Sl. No. Challan No. (CIN) Date of Payment Bank Name Amount (Rs.) (1) (2) (3) (4) (5) 1         2         7. Verification I, ___________________________ (Name of Authorized Signatory), son/daughter of ___________________, hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. I understand that the Cess has been self-assessed as per the capacity determined under section 5 of the Act. ....