Form ER-4
Original/Duplicate
[See rule 12(2)(a) of the Central Excise Rules, 2002]
ANNUAL FINANCIAL INFORMATION STATEMENT FOR THE FINANCIAL YEAR _______
(All figure relating to value and amount to be given in Rs. lakhs)1. Registration number ccccccccccccccc2. Name of the assessee ccccccccccccccc3. Details of expenditure:(i) Details of inputs including packing material and components used for manufacture.(a) Total value of inputs including packing materials and components used for manufacturing on which CENVAT credit availed (value as per purchase invoice or import document excluding all taxes). Rs(b) Total value of inputs including packing materials used for manufacturing on which CENVAT credit not availed. Rs(c) Value of raw material including packing material and components consumed as per Profit and loss account. Rs.(ii) Value and quantity of each major raw material consumed in the manufacture of goods#.(a) Description of raw material Raw Material A
| | Quantity (Please specify the unit also) | Value |
| Opening stock of Raw material | | |
| (+) Purchase of raw material | | |
| (-) Closing Stock of Raw Material | | |
| Raw Material consumption | | |
(b) Please state description of final product {as mentioned at Sr. No. 4 (ii) below}, where the raw material is principally used(iii) Details of other expenditure (a) Total Inward Freight Rs (b) Total Outward Freight Rs (c) Advertisement/Sales Promotion Rs (d) Commission paid for sales of manufactured goods Rs (e) Total R & D expenditure Rs (f) Wages Rs (g) Power and Fuel Rs (h) Other expenses* {excluding (a) to (g) above}. Rs(iv) Details of goods got manufactured by the assessee through job workers: (a) Whether goods are got manufactured through job worker? Yes/No (b) If yes, whether any raw material/inputs are supplied to job worker? Yes/No (c) Whether any raw material/inputs are used by the job worker which Yes/No are not supplied by the assessee? (d) Total amount paid by the assessee to job worker. Rs. 4. Details of Income:(i) Total Sales value (Gross) as per Profit & Loss account Rs(ii) Value and quantity of each major manufactured finished goods sold@. Please mention description and Chapter sub-heading. Finished Good ŒA¹| | Quantity (Please specify the unit also) | Value (excluding Taxes) |
| Opening stock of finished goods | | |
| (+) Production of finished goods | | |
| (-) Closing Stock of finished goods | | |
| Finished goods sold | | |
(iii) Details of trading activity {excluding inputs cleared as such as per Sr. No.(viii) below}
| | Quantity (Please also specify the unit) | Value
(excluding Taxes) |
| Opening stock of Trading Goods | | |
| (+) Purchase of Trading Goods | | |
| (-) Closing Stock of Trading Goods | | |
| Trading Goods sold | | |
(iv) Sale value of non-excisable and fully exempted goods (excluding the goods exported) cleared during the financial year. Rs(v) Value of goods exported under Bond (vi) Value of goods exported under claim for rebate Rs(vii) Total value of sale of waste and scrap. Rs(viii) Value of inputs on which CENVAT credit has been availed and cleared as such: (a) On payment of amount equal to the credit availed. Rs (b) Without payment of any such amount to job worker (excluding the value of both the inputs as such or the inputs used in job worked goods, received back by the assessee from job worker). Rs(ix) Total Sales Tax paid. Rs(x) Details of other income:
| Sl. No. | Category | Amount |
| 1. | Warranty charges from buyers | |
| 2. | Advertisement / Marketing Expenditure recovered from customers | |
| 3. | Handling, storage, packing & forwarding charges | |
| 4. | Pre-delivery inspection charges | |
| 5. | Product development, Drawing, design and development charges | |
| 6. | Transportation charges received | |
| 7. | Erection & Commissioning charges received | |
| 8. | Technical, Engineering, Consultancy etc. charges received | |
| 9. | Other receipts/income {excluding (1) to (8) above} | |
(xi) Total Other income as per Profit and Loss Account. Rs(xii) Details of job work undertaken by the assessee for others:
| (a) | Whether any such job work activity carried out by the assessee? | Yes/No |
| (b) | Whether job work done using own raw material / inputs (i.e. other than those supplied by the person for whom job-work is done). | Yes/No |
| (c) | Whether job work goods are cleared on payment of duty
[OLD-
Whether job work goods are cleared on payment of duty or without payment of duty ] | Yes/No |
| (d) | Total amount of job work charges received during the financial year | Rs. |
(Above para 4 (xii),(c) has been corrected vide
CORRIGENDUM Dt. 09/11/2004)
5. CENVAT Credit details:
| | Credit Availed (Rs.) | Credit utilised (Rs.) |
| On inputs | | |
| On Capital Goods | | |
| On Taxable input Service | | |
6. (i) I/We ________________declare that the particulars declared above have been compared with the records and books of my/our factory/warehouse and the same are true and correct to the best of my/our knowledge.
(ii) I/we am/are authorized to sign this return.
(Name in capital letters and signature
of the assessee or authorized signatory)
Place:
Date:
Note: # To be given separately and distinctly for each major raw material consumed on the lines of Sl. No. 3 (ii) (a) (1) of Part II of the Schedule VI pertaining to section 211 of the Companies Act, 1956(1of 1956), i.e. each such raw material which in value independently accounts for 10 % or more of the total value of the raw materials consumed.
* other expenses include all expenses like interest, depreciation, other overheads as shown in Profit and loss Account.
@ To be given separately and distinctly for each class of major finished goods sold i.e. each such finished goods which in value independently accounts for 10 % or more of the total value of the finished goods sold as clarified in Note 3 to the para 3 of Part II of the Schedule VI pertaining to section 211 of the Companies Act, 1956(1 of 1956).
Please enclose copy of Profit and Loss Account and Balance Sheet.
ACKNOWLEDGEMENT| Annual Financial Information Statement For The Financial Year ___________ |
Name and Signature of the officer with seal
Place:
Date:
NTF. NO. 36/2004-CE(N.T.), DT. 01/11/2004