In exercise of powers conferred by rule 9 of the Central Excise (No.2) Rules, 2001, the Central Board of Excise and Customs hereby makes the following amendments in the Ministry of Finance (Department of Revenue), Notification No. 35/2001-Central Excise (N.T.) dated the 26^th June, 2001, namely:

In the notification,

(a)       for Annexure-l, the following shall be substituted namely:

�Annexure I

Original

Duplicate

FORM A �1

REQUEST FOR CENTRAL EXCISE REGISTRATION

1. Legal Name of the Business

2. Permanent Account Number (PAN)

(Issued by the Income Tax Department) (Self attested copy to be enclosed)

3. Specify (Tick the box):

4. Address of the Business

Telephone Nos.                                                                            Fax Nos.

E-mail Address

5. Define boundaries of the premises to be registered

6. Address of Head Office, if any

Telephone Nos.                                                                            Fax Nos.

E-mail Address

7. Name designation and address of contact person/ authorised person:

Last Name                                                  First Name                                       Middle Name

Designation

Permanent Account Number (PAN)

 Issued by the Income Tax Department)

Address

Telephone Nos.                                                                            Fax Nos.

E-mail Address

1. Specify (Tick the box):

2. Registration No.

3. Legal Name of the Business

4. Address of the Business

Telephone Nos.                                                                            Fax Nos.

E-mail Address

Please furnish the aforesaid information for each of the other such factory (ies)/ warehouse (s)/ dealer�s premise (s).

1. Individuals- Permanent Account Number (PAN)

Last Name                                                  First Name                                       Middle Name

Address

1. Has the applicant ever owned any business in the past?

A. Name of the Business