Application for removal of excisable goods for export by (Air/Sea/Post/Land) - [See Rule 18/19 of the Central Excise Rules, 2002 read with Notification Nos. 19/2004-C.E. (N.T.) and 42/2001-C.E. (N.T.)]

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..... Deputy Commissioner of Central Excise/Maritime Commissioner of Central Excise from whom rebate shall be claimed/with whom bond/undertaking is executed and his complete postal address. 2. I/We ........ of ..............propose to export the under-mentioned consignment to ........... (Country of destination) by Air/Sea/Land/Parcel Post under claim for rebate/bond/undertaking*. Particulars of Manufacturer of goods and his Central Excise Regis-tration No. No. and Description of packages Gross weight/ Net weight Marks and Nos. on packages Quantity of goods Description of goods Value Duty No. and date of Invoice under which duty was paid/No. and date of bond/undertaking executed under rule 19 Amount of Rebate claimed Remarks Rat .....

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..... .....……….[F. No.___________________], duly accepted by the Assistant Commissioner/Deputy Commissioner of Central Excise________on _________(Date). 2. Certified that I have opened and examined the packages No.....……………………………………………......... and found that the particulars stated and the description of goods given overleaf and the packing list (if any) are correct and that all the packages have been stuffed in the container No. ............... with Marks .................. and the same has been sealed with Central Excise Seal/One Time Seal (OTS) No. ............. 3. I have verified with the records, .....

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..... Officer of Customs in Block Letters)/(Seal) PART C Export by Post Certified that the consignment described overleaf has been dispatched by foreign post to ……………………… on ……………….. day of 200………. Place ……….. Date ………. Signature of Post Master with seal PART D Rebate Sanction Order (On Original, Duplicate and Triplicate) Refund Order No……………………………… dated ………..…………….. Rebate of Rs………………&hell .....

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