ANNEXURE-56
TEXTILE QUARTERLY STATEMENT FORM
[See Rule 8A(v)]

1. RETURN FOR THE QUARTER ENDING ON------------

2. NAME AND ADDRESS OF THE EXEMPTED WEAVER (MANUFACTURER):

3. DECLARANT CODE: (12 DIGIT CODE)

4. DETAILS OF INPUTS RECEIVED (TO BE GIVEN SEPARATELY FOR EACH TYPE OF YARN);

Opening balance	Receipt during quater	Consumed during quater	Closing balance
1. Quantity (in Kgs /meters) 2. Value (in Rs.) 3. Excise duty involved (in Rs.)	1. Quantity (in Kgs /meters) 2. Value (in Rs.) 3. Excise duty involved (in Rs.)	1. Quantity (in Kgs /meters) 2. Value (in Rs.) 3. Excise duty involved (in Rs.)	1. Quantity (in Kgs /meters) 2. Value (in Rs.) 3. Excise duty involved (in Rs.)
1. 2. 3.	1. 2. 3.	1. 2. 3.	1. 2. 3.

5. DETAILS OF FABRICS CLEARED DURING THE QUARTER (TO BE GIVEN SEPARATELY FOR EACH TYPE OF FABRICS)

Opening balance	Manufactured during quater	Removed during quater	Closing balance
1.Quantity (in Kgs /meters) 2. Value (in Rs.) 3.Credit of excise duty involved (in Rs.)	1. Quantity (in Kgs/ meters) 2. Value (in Rs.) 3. Credit of excise duty involved (in Rs.)	1. Quantity (in Kgs/ meters) 2. Value (in Rs.) 3. Credit of excise duty passed on (in Rs.)	1. Quantity (in Kgs/ meters) 2. Value (in Rs.) 3. Credit of excise duty involved (in Rs.)
1. 2. 3.	1. 2. 3.	1. 2. 3.	1. 2. 3.

6. CUMULATIVE VALUE OF CLEARNCE DURING THE FINANCIAL YEAR, SINCE 1ST MAY, 2003
(In Rs.)------------------------------------------------

7. ENCLOSE DUPLICATE COPIES OF CHALLAN SERIAL NOS.
(FROM)--------(TO)---------------

8. ENCLOSE ORIGINAL COPIES OF INPUT DUTY PAID INVOICES

DECLARATION

I hereby declare that the facts stated above are true and correct.

(Signature of Proprietor/Partner/Authorized person)

(Above Annexure 55 has been vide NTF. NO. 54/2003-CE(N.T.), DT. 09/06/2003)