ANNEXURE-21

INVOICE

ORIGINAL
DUPLICATE
TRIPLICATE
QUADRUPLICATE

Invoice of goods liable to Central Excise Duty in India transmitted under
Central Excise Seal to Nepal
Invoice No. ______________ Date_____________

Range_____________ Division___________ Commissionerate _______________ from _______________
(factory/warehouse) by ___________________________
through the Border Post of_______________(Merchants Name) ______________________

Marks and numbers of packages	Marks and numbers of packages	Numbers and description of packages	Description of good with tariff classification	Net weight, value or quantity	Value (words and figures)	Rate of duty	Amount of duty paid or payable (In Words and figures)	Number and date of document under which Central Excise Duty was paid or is payable	Gross weight of packages	Number and date of railway receipt, if any

1) I/We hereby declare that the above-mentioned particulars are true and correctly stated andthat the consignment of goods is intended for export to Nepal ______(place) and shall not bediverted en route to any other country.

Signature of exporter or his authorised agent.

Place:

Date:


2) Certified that the above-mentioned packages have been identified by me and sealed with theCentral Excise seal under my supervision.

Signature and designation of the Officer of Central Excise.

Running Serial No.
Date:
(to be given in red ink and encircled by the Border Examiner)
3) Certified that the above-mentioned consignment has been duly identified by me and haspassed the Border Customs Post.

(Running Serial number of the Border Check Post
to be written in red ink prominently encircled)

Signature and designation of the Indian
Officer-in-charge of the Border Customs Postal__________.

4) Certified that the above-mentioned consignment/packages have been duly identified by meand have been received and accounted for in Nepal.

Signature and designation
(with official seal) of Nepalese Customs Officer.
Check Post ____________

(Back to Part-IV of Ch.7 & Part-II of Ch.8)

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