FORM A.R.E.

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APPLICATION FOR REMOVAL OF EXCISABLE GOODS FOR EXPORT BY [AIR / SEA / POST / LAND]*
A.R.E.1 No. Date Original Duplicate Triplicate Quadruplicate White Buff Pink Green

Range Division Collectorate : To, Superintendent of Central Excise,

Address

1. Particulars of Asst./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 __________________________________________________________________________________________ purpose to export the undermentioned consignment to (Country of destination) [by Sea / Land / Parcel Post]* under claim for rebate / bond / under taking*.
Particulars of Manufactures of goods and his Central Excise Reg. No. 1 No. & Description of Packages Gross Weight / Net Weight 3 Gross Weight Net Weight Nos. Total : 0 Total Ass.Value : Total Duty % 10.30% Total Duty 0.00 Marks & Nos. on Packages 4 Quantity of Goods (METER) 5 Meter Description of Goods Value (In words as well as in figures) 7 Duty No. & Date of Invoice under (In words as which duty was paid/No. and well as in figures) date of bond/under taking executed Rate % Amount Rs. under Rule 19 8 9 10 10% 0.00 2% 0.00 INVOICE NO : 1% 0.00 INVOICE DT: Amount of Rebate Claimed 11 Remarks

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3. I / We hereby certigy that the above mentioned goods have been manufactured (a) Availing facility / without availing facility of Cenvat Credit under Cenvat Rules, 2002 (b) Availing facility / without availing facilty Under Notification 21/2004 - Central Excise (N.T.) Dated 6th September 2004, issued under Rule 18 of Central Excise (No.2) Rules 2002. [c] Availing facility / Without availing facility under Notification 43/2001 Central Excise (N.T.) Dated 26th June 2001, Issued under Rule 19 of Central Excise (No.2) Rules 2001. 4. I / We hereby declare that the export is in discharge of export obligation under a Quantity based Advance Licence / Under Claim of Duties Drawback under Customs & Central Excise Duties Drawback Rules, 1995*. 5. I / We hereby declare that the above particulars are true and correctly stated. Time of Removal HRS

This is to certify that the copies of the application (A.R.E.1) that the description and value of the goods coverd by this A.R.E.1 have been checked by me and the goods have been packed and sealed with lead seal / one time local seal having number ______ under my supervision.

*Strike out whichever is not applicable

Signer of owner or his authorized agent with date Name in Block Letters & Designation (SEAL)

PART A CERTIFICATION BY THE CENTRAL EXCISE OFFICER

X1. Certified that duty has been paid by debit entry in the Personal Ledger Account No. or recorded as payable in Daily Stock Account on the goods described overleaf. OR Certified that the owner has entered into Bond No. under Rule 19 of Central Excise (No.2) Rules 2001 with the [F.No. ___________________________________________________ Deputy Commissioner of Central Excise on GOODS CLEARED UNDER SRP _________ and / or CENVAT Account Entry No. ___________

duty accepted by the Assistant Commissioner / (Date).

X2. Certified that I have opened and examined the packages No. _____________________________ 0 description of goods given overleaf read with the invoice and the packing list (if any) correct and that all the packages have been stuffed in the container No._________________________________________ with Marks ______________________________and the same has sealed with Central Excise Seal/One time Seal (OTS) No. _____________________ 3. I have verified with the records, the exporter is only availing the export incentives as specified in box No.6 and found it to be true. X4. Certified that I have drawn three representative samples from the consignment (Whatever necessary) and have handled over two sets thereof duly sealed to the exporter / his authorised representative.

been

Place : Date :

Signature (Name in Block Letters) Superintendent of Central Excise

Signature (Name in Block Letters) Inspector of Central Excise

PART B CERTIFICATION BY THE CUSTOM OFFICER

Certified that the consignment was shipped under my supervision under shipping bill No. Which left on the day of 2010 OR Certified that the above mention consignment was stuffed in Container No. ______________ belonging to shipping Line ____________________ based on the "Let Export Order" given on _____________ day of ____________ (Month) ______________ (Year). On the Shipping bill No. ________________ Dated ________ and sealed / one time lock on ____________________ in my supervision and the container was handed over to the Custodian M/s. ________________________ for being shipped via ____________________________ (Name of the Port) OR Certified that the above mentioned consignment has been duly identified and has passed the land froniter today at ___________ in its original condition under Bill of Export No. ________________________ dated by S.S. / Flight No.

Place : Date :

Signature (Name and designation of the Customs Officer (Name in Block Letters) (Seal)

PART C EXPORTS BY POST

Certified that the consignment described overleaf has been despatched by foreign post to _____________ on _____________ day of __________________2010. Place : Date : Signature of Post-Master Seal

PART D REBATE SACTION ORDER

(On Original, Duplicate and Triplicate) Refund Order No. _________________ Dated _______________________ Rebate of Rs. _______________(Rupees ___________________________________ ________________________________) sanctioned vide cheque No. ________________ Dated ______________ Place : Date : Signature Asst./Deputy Commissioner/Maritime Commissioner of Central Excise *Strike out inapplicable Portion