Central Excise Rules
Chapter 2-COLLECTION AND ASSESSMENT OF CESS

"FORM -I

Monthly Return for Removal of specified goods

(See rule 11)

Return for Specified Goods for the Month

I. (1) Registration Number :
(2) Name of the Producer :
(3) Full Address :

II. Details of Specified Goods removed and Cess payable

S.No.	Name of the mine along with address	CETSH NO.	Description of specified goods	Unit of quantity	Quantity of specified goods removed during the month (in MT)	Rate of cess per tonne (Rs. per tonne)	Notification availed	S.No. in notification	Total cess payable as per billing (Rs.)
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)

(This part is to be repeated for each CETSH and for each mine, in case a producer has obtained centralized registration)

III. Details of payment:

Total Cess paid (Rs.)	Amount of Cess adjusted during the month under Rule 6(3)	Source document	Cess Code	Challan No. (CIN)	Remarks
(1)	(2)	(3)	(4)	(5)	(6)

(Total Cess paid should include Cess payment made during the month through challan as well as excess payment adjusted from earlier month(s).)

IV. Details of other Payments:

Payments	Amount paid in cash(Rs.)	Challan No. (CIN )	Source document
Payments	Amount paid in cash(Rs.)	Challan No. (CIN )	No.	Date
Arrears of CESS under rule 6
Other arrears
Interest payment under rule 6(4)
Other interest payments
*Miscellaneous payments
Total

(*Miscellaneous payments include penalty, pre-deposit, redemption fine.)

V. (a) I hereby declare that the information given in this return is true, correct and complete in every respect and that I am authorized to sign on behalf of the assessee.

(b) During the month a total amount of Rs._____ was deposited vide TR-6 Challan (copies enclosed).

	(Name and Signature of the Assessee or Authorised signatory)

Place:
Date :

ACKNOWLEDGMENT

				M	M		Y	Y	Y	Y
Return of Specified Goods

	D	D		M	M		Y	Y	Y	Y
Return of Specified Goods

(Name and Signature of the Range Officer with Official Seal)

INSTRUCTIONS

1. In case where a producer has obtained a centralized registration under Rule 3 of Clean Energy Cess Rules 2010 he should provide information in respect of table No. II and V (c) in respect of each Mine separately.

2. In case more than one item is produced, additional row may be inserted in each table.

3. 8-Digit CETHS No. may be indicated without any decimal point.

4. The details of the challans for duty payment should be mentioned in Table II. Separate challans should be used for pre-deposit of duty for the purpose of appellate remedy.

5. In the sixth column of Table at serial number IV specify the Order-in-Original number and date relating to the payment of arrears of duty and of interest, the period for which the said interest has been paid. For other miscellaneous payments, mention the source document number and date."