Form ARE. 4
- Document type
- Form
- Dated
- Category
- BONDS, FORMS, RETURNS, REGISTERS
Declaration and Assessment Memorandum
(in triplicate)
(See rule 30A)
| Commissionerate……………………….. | Original |
| Division………………………………… | Duplicate |
| Range…………………………………… | 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 ………….
- (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 ………….
Treasury
Sub-Treasury
Bank
Reserve Bank of India
(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 Account | Number and Date of Entry | Amount (Rs.) |
………………….
(Signature of the owner or authorized agent)
Date………….
(Note:- see Ntf. No.03/2002-CE(N.T.), dt. 22/02/2002 and Ntf. No.30/2001-CE(N.T.), dt. 21/06/2001)