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FORM A-1 New Central Excise Registration form. To fill this form Please see Instruction-1 and Instruction-2
August, 12th 2013
                                                                                           Duplicate
                                             Form A-1
                       APPLICATION FOR CENTRAL EXCISE REGISTRATION
                             (see rule 9 of Central Excise Rules, 2002)


 New Registration

 Amendments to information pertaining to
 existing Registrant

 Registration Number in case of existing
 Registrant


Part I: Identification of business requiring Registration (Manufacturing, Warehousing,
         hundred percent Export Oriented Undertaking, Unit in Export Processing Zone , First
         Stage Dealer, Second Stage Dealer )

1.         Name of the Registrant (Please see instruction No. 5)




2.      Details of Permanent Account Number (PAN) (Please see instruction No.6)


        Whether PAN has been issued by the Income Tax
(i)                                                                      Yes                No
        Department

(ii) If yes, the PAN


(iii)           Name of the Registrant (as appearing in PAN)



(iv) If PAN is not available, whether applied for PAN                    Yes                No


3.      Category (tick only one box)

Manufacturer                                             Warehouse
Export Oriented                                          Unit within Export Processing
Undertaking                                              Zone
Manufacturer's Depot                                     Dealer


4.      Constitution of business (tick only one box) (Please see instruction No. 7)

Proprietorship                          Partnership                   Registered Company
Unregistered Company                    Trust                         Society                          Others

5.      Address of business premises
(i)       Name of Premises/Building
(ii)     Flat/Door/Block No.

(iii)    Road/Street/Lane

(iv)     Village/Area/Locality

(v)      Block/Taluk/Sub-Division/ Town

(vi)     Post office

(vii)    City/District

(viii)   State/Union Territory

 (ix)    PIN

(x)      Telephone Nos.: (Please see instruction No.8)

(xi)     Fax No. (Please see instruction No. 8)

xii)     E-mail Address


6.       Define boundaries of the premises to be Registered (Please see instruction No.9)
(i)      North

(ii)     East

(iii)    West

(iv)     South


7.       Details of property holding rights of the Registrant with respect to the premises sought to
         be Registered (tick only one box)


Ownership                                                 Lease/Rent

If owned whether mortgaged/ hypothecated:                              Yes                  No

8.       Estimated investment in land, plant and machinery (Rupees in Lakh):



9.       Address of Head Office if different from that given at S.No. 5 above

(i)      Name of Premises/Building

(ii)     Flat/Door/Block No.

(iii)    Road/Street/Lane
(iv)     Village/Area/Locality

(v)      Block/Taluk/Sub-Division/ Town

(vi)     Post office

(vii)    City/District

(viii)   State/Union Territory

 (ix)    PIN

(x)      Telephone Nos.: (Please see instruction No.8)

(xi)     Fax No. (Please see instruction No. 8)

(xii)    E-mail Address


10.     Name, designation and address of the person signing this Application Form and of the
authorised person(s): (Please see instruction No.10)

(i)      Name

(ii)     Designation

(iii)    Name of Residential Premises/Building

(iv)     Flat/Door/Block No.

(v)      Road/Street/Lane

(vi)     Village/Area/Locality

(vii)    Block/Taluka/Sub-Division/ Town

(viii)   Post office

(ix)     City/District

(x)      State/Union Territory

(xi)     PIN

(xii)    Telephone Nos.: (Please see instruction No. 8)
(a)      Office

(b)      Residence

(xiii)   Fax No. (Please see instruction No. 8)
(xiv)      E-mail Address


11.                                                                                  Please see
           Details of Bank Accounts used for business transactions by the Registrant (
           instruction No. 11)


(a)     Number of Bank Accounts

(b)     Account 1
(i)              Name of the Bank

(ii)            Name of the Branch

(iii)           Account No.


(c)        Account 2
(i)             Name of the Bank

(ii)            Name of the Branch

(iii)           Account No.


Part II:      Business Transaction Number obtained from other Government
               Agencies/Departments

12.         Details of Business Transaction Numbers obtained from            other   Government
           Agencies/Departments (Please see instructions No. 12 and 13)


(i)     Customs Registration No. (BIN No.)       Yes                    No
           If yes, give details



        Directorate General Foreign Trade's Import
(ii) Export Code No.
                                                         Yes            No
           If yes, give details


(iii)      Sales Tax Registration Nos.


(a)           State Sales Tax No.                Yes                    No

           If yes, give details



(b)     Central Sales Tax No.                    Yes                    No
           If yes, give details
(iv) Registrar of Company's CIN No.                  Yes               No
            If yes, give details


Part III:      Proprietor/Partners/Chief Executive Officer /Chairman /Managing
                Director/Trustee etc.

13.      Mode of business (Please see instruction No. 14)
(i)      Name

(ii)     Designation

(iii)    Name of Residential Premises/Building

(iv)     Flat/Door/Block No.

(v)      Road/Street/Lane

(vi)     Village/Area/Locality


(vii)    Block/Taluk/Sub-Division/ Town

(viii)      Post office

(ix)     City/District

(x)      State/Union Territory

(xi)     PIN

(xii)    Telephone Nos.: (Please see instruction No. 8)

(a)         Office

(b)      Residence

(xiii)      Fax No. (Please see instruction No. 8)

(xiv)    E-mail Address

(xv)     PAN (issued by the Income Tax Department)



PART IV: Major Excisable goods to be manufactured, warehoused or traded/ Major
          inputs

14       Major excisable goods manufactured, warehoused or traded (description and CETSH)
         (Please see instruction No. 15 )
(i)______________________ (ii) ____________________ (iii) ____________________

15.     Major excisable goods used in the manufacture of final product (description and CETSH)
          (Please see instruction No. 15)
(i)______________________ (ii) ____________________ (iii) ____________________







                                             DECLARATION

I, ________________________________________________ hereby declare that the
information
given in this Application Form is true, correct and complete in every respect and that I am
authorised to sign on behalf of the Registrant.

(Please tick appropriate box)


(a) For new Registration/Amendment to Registration
    Certificate
      I would like to receive the Registration Certificate
      ­
      by mail at the address specified at S. No. ______
      of Part-I
      by Hand

(b) For amendments to information pertaining to
    existing Registrant
      The above mentioned amendments are with effect
      from                                                            /            /

                                              (Signature of the applicant/authorised person with
stamp)
                                                                   (Please see instruction No. 16 )
Date:
Place:



                                      ACKNOWLEGEMENT
(To be given in the event Registration Certificate is not issued at the time of receipt of Application
                                         for Registration)


I hereby acknowledge the receipt of your Application Form

(a) For  new Registration / amendments to existing
     Registration Certificate
      As desired, the New Registration Certificate will
      be sent by mail/ handed over to you in person on                /            /
(b) For amendments to information pertaining to
    existing Registrant
                                                                   Signature of the Officer of Central Excise
                                                                                  (with Name & Official Seal)
Date:


                      Instructions for filling up the Application Form for Registration

1)                This Application Form should be used for applying for Registration as also for
            informing any corrections/ changes in the information, subsequent to Registration. Any
            change in the information subsequent to Registration, except those under Part IV, must
            be brought to the notice of the Central Excise Department. Such changes should be
            indicated by ticking the relevant box at the top of the Form, providing the Registration
            Number and filling up only such information that has undergone change leaving the
            boxes for information not to be amended blank.
2)                The Application Form has to be filled in Duplicate, and submitted to the Deputy
            Commissioner of Central Excise or Assistant Commissioner of Central Excise, having
            jurisdiction over the place of business.
3)                Export Oriented Units and Units in Export Processing Zones in the Port Towns/cities
            which are in the jurisdiction of Commissioners of Customs would submit the Application
            Form to the concerned Deputy Commissioner of Customs or Assistant Commissioner of
            Customs.
4)                After entering the relevant details, extra boxes in a field may be left blank. Also one
            box may be left empty after completion of each entry. For example more than one
            telephone number may be given as under:
0 1     1     3   0     9   2   8   2   9    0   1     1   3   0    9   2   8   3   0





5)                The name should be the name and style in which the Registrant is likely to carry out
            business from the premises seeking to be registered. Please do not mention any prefixes
            such as M/s, Mr., Sh., etc
6)                An attested copy of PAN allotted by the Income Tax Department should be
            enclosed; in case PAN has not been allotted attested copy of the acknowledged
            application for PAN should be enclosed.
7)                 A registered company means, a company registered with the Registrar of
            Companies under the Companies Act, 1956 (1 of 1956) and having a CIN number.
            Unregistered means a company that is not so registered
8)          Telephone and fax numbers to be given with NSD code, without leaving a gap.
9)          The description of the boundaries of the premises to be registered, should correspond to
            the one given in the Land Records.
10)   If there are more than one authorized persons, information is to be provided in respect of
      all in a separate sheet in the same box format.
11)   In case the Registrant has more than one Bank Account, for transacting his business,
      only two accounts with the maximum transactions must be mentioned.
12)   The details relevant to the Registrant only are to be filled. The details of businesses
      carried out from other premises need not be filled.
13)   If the status of the company is shown as Registered Company in Part I 4, then the
      information in Part II 12 (iv) is mandatory.


14)   The maximum number of persons, whose details are to be provided, should not exceed
      seven. In the case of a partnership firm, details of partners are to be provided; in case of
      Registered /unregistered company, the details of its Chief Executive Officer /Chairman
      and Managing Director/Managing Director/Chairman/ key Directors as per relevance are
      to be provided; in the case of Society, the details of its President, key Executive
      Members, are to be provided; in case of any other type of business, the details of key
      personnel engaged in management of the business are to be provided. If more names
      are to be provided the information shall be provided in respect of all in a separate sheet
      in the same manner.
15)       The    details   of   the   three   major     excisable   goods/inputs   likely   to   be
      manufactured/used/traded should be mentioned.
16)   The instructions in respect of the person signing the Application for registration are as
      under:
        (a)           The Application may be signed by the Registrant himself or by his
                authorised agent having general power of attorney.
        (b)          The person signing the Application must be a holder of Permanent Account
                Number (PAN) allotted by the Income Tax Department.
        (c)           In case of unregistered partnerships, all the partners should sign the
                application.
        (d)          In case of registered Partnership the Managing Partner or other partners
                so authorised in the Partnership Deed may sign the application.";
 
 
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