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Serial NO

Name and Address of Manufacturer or


Impoter inculiding central excise Range,
Manufacturer
or Division
and
Commissionerate,Customs
importer invoice NO. House and his New Excise Control Code
or
Bill
of
Entry (Manufacturer)
or
Import/Export
NO.and Date
Code(Importer)
2
3

Rate of Amount
of duty (both in
words
and
figures)
4
12% per unit

Quantity

Total Amount of
duty(both
in Description
Words
and Goods
figures
6

of

Invoice No and Date or Name and Address of Manufacturer or


Bill of Entry and date,of Impoter
inculiding
central
excise
Quantity
the Supplier If he is not Range,
Division
and
Manufacturer or Importer Commissionerate,Customs House
8

10

Rate of Amount
Tarift Heading or of duty (both in Invoice
Sub -heading
words
and Date
figures)
11

12

No.and

13

Name of the Cstomers to Whom goods


are Sold including Central Excise
Quantity
Range,Division
and
Commisionerate,Customs House
14

Rate
of
Amount of duty
(both in words
and figures)

15
12%

16
- 3%