Application for filing a claim of rebate of duty paid on inputs, service tax and cess paid on input services

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..... ommissioner of Central Excise ..(full postal address). Madam/Sir, I/We ..,(name of the person claiming rebate) holding service tax registration No. , located in . (address of the registered premises) hereby declare that I/We have exported service (name of the taxable service) under rule 5 of the Export of Service Rules, 2 .....

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..... bate. 1. 2. 3. Declaration: (a) We hereby certify that we have not availed CENVAT credit on inputs and input services on which rebate has been claimed. (b) We have been granted permission by Assistant Commissioner of Central Excise or Deputy Commissioner of Central Excise, vide C. No. .., datedfor working under notification No .. , dated . (Signature and na .....

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