ANNEXURE-03

Surrender of Registration Certificate

To

The Superintendent of Central Excise,
(Address of the Range)_____________
________________________________
Subject: Surrender of Registration Certificate –
I/We, _________________________________ of M/s ________________________,duly authorised in this behalf by the proprietor/ firm/company declare that we do not require registrationwith the Central Excise and therefore hereby surrender and deposit with you the original copy of theRegistration Certificate No. ________________________ issued to me on _______________ (date) interms of the provisions of rule 9 read with notification No. ___________________ dated ___________ .

I/We further declare that duty has been paid in respect of all excisable goods manufactured and remainingin the factory, which are liable to duty.

I/We also declare that there is no government due pending against us and that there is no demand pendingagainst us under Central Excise Act, 1944 (1 of 1944) and rule made thereunder pending as on the date ofsurrendering the Registration Certificate.

Signature of the Registrant or the authorised signatory
with full name, date and seal.

Acknowledgement
I hereby acknowledge receipt of “Registration Certificate No.____________________ in original.Surrender of registration shall be subject to correctness of the declaration made above.

Superintendent of Central Excise
with full name, date and seal.

Presented by eximkey.com