FORM ER-5
{sub-rule (1) of rule 9A of CENVAT Credit Rules, 2004}
1. Name of the manufacturer:
3. Annual Declaration
(i) New declaration
(ii) Amendments to declaration already filed
(Pl. tick the appropriate box)
4. Declaration for the Financial Year ___________
*NOTE. - Please indicate the abbreviation referred to in Instruction No. 7 mentioned in Form E.R.-1 and Form E.R.-3 specified in the Government of India, Ministry of Finance (Department of Revenue) vide No.25/2004-Central Excise (N.T.), dated the 27th September, 2004 published vide G.S.R.No.643 (E) dated the 25th September, 2004.
5. (i) I/We _________________hereby declare that the information given above is true, correct and complete in every respect to the best of my/our knowledge and belief.
(ii) I/We am/are authorized to sign this declaration.
(Name in capital letters and signature of the assessee or authorized signatory)
Place:
Date:
ACKNOWLEDGEMENT
Name and signature of the officer with seal