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22
nd
of February, 2002
Notification No.3/2002-Central Excise (N.T.)
In pursuance of rule 30A of the Central Excise (No.2) Rules, 2001, the Board hereby notifies the proper form for the purposes
of this rule, namely:-
"Form ARE. 4
(in triplicate)
(See rule 30A)
Commissionerate.............................
Division.......................................
Range..........................................
Original
Duplicate
Triplicate
Number and date
of entry in daily
stock account
Number and
description of
packages
Gross
weight of
packages
Marks
and
numbers
Description of
goods with Tariff
classification
Value for
assessment
purpose
Duty
Number and
date of
Invoice
Issued
Remarks
Rate
Amount
(Rs.)
Rate
Amount
(Rs.)
(1) (2) (3) (4) (5) (6) (7)(8) (9) (10)(11)
Notes :
1. Where there are different types of duties, separate entries should be made on different horizontal lines and the amount
totaled.
2. Value for Assessment purpose is the value as per section 3 or 4 or 4A of the Central Excise Act, 1944.
Declaration
I/We declare the above particulars to be true and correctly stated.
I/We apply for leave to clear the above goods.
..............................
(Signature of the owner or authorized agent)
Place.............
Date .............
Assessment Memorandum
(To be entered in words and figures)
1. Total number of packages...................
2. Quantity of goods on which duty is assessed..............
3. Rate of duty..............
4. Total duty payable.................
..............................
(Signature
............of Central Excise)
Place.............
Date .............
Statement of duty paid at.........
Treasury
Sub-Treasury
Bank
Reserve Bank of India
I. For payment in cash
(to be filled the owner or authorized agent)
Name of the person tendering
payment
Name and address of the person on whose behalf the
amount is tendered
Particulars of
payment
Amount
(Rs.)
Head of
account
(1) (2) (3) (4) (5)

1. Excise duty on....... (name of commodity)
2. Additional duties of excise under .............(Act)
Total Rupees (in words).............................
Date.................
Deposit No.........
...........................
(Signature of the Tenderer)
(To be filled by the Treasury or Bank)
Received payment of rupees (in words) .........................
..............................
(Signature of the Treasurer/Accountant/Treasury Officer/Agent or Manager)
Date.............
II. Payment through Account Current /CENVAT account
Title of AccountNumber and Date of EntryAmount (Rs.)
......................
(Signature of the owner or authorized agent)
Date............. .".
M.G.Thamizh Valavan
Under Secretary to Government of India
F.No. 201/18/2002 CX 6
Footnote.-
The principal rules were published in the Gazette of India, Extraordinary vide GSR. 444(E), dated the 21
st
June, 2001.
notifications no 03 2002 ce n t | iKargos