Annexure-5 (In Duplicate) (To be filed in the jurisdictional Range Office) FORMAT FOR APPLICATION FOR OBTAINING NEW EXCISE CONTROL CODE NUMBER (Manufacturers/Registered Dealers/Warehouses) To The Deputy/Assistant Commissioner, (Address of the Division). Subject: Allotment of New Excise Control Code Number - Regarding - Sir, I/We may kindly be allotted New Excise Control Code Number (New ECC Number) for which the details are as under: - FORMAT FOR THE DETAILS (All entries shall be in BLOCK letters) 1. Name of the Applicant(s) _________________________________________________ 2. Permanent Account Number ______________________________________________ (Issued by the Income Tax Department ) (Attested copy to be enclosed) 3. Applicant's Factory/Warehouse/Registered Dealer's Premise (Strike whichever is not applicable) Existing ECC Number : Registration Number : Address : Telephone Nos. : Fax Nos. : E-mail Address : Range________________ Division______________ Commissionerate_______________ Location Code (6 digit - To be filled by the Range Office) _________________________ 4. OTHER* Factories/Warehouses/Registered Dealer's Premises (Strike whichever is/are not applicable) *[Each of these Factories/Warehouses/Registered Dealer's Premises have to apply individually in their own jurisdictional Range Office(s)] Sl. No. Name and address Whether factory OR warehouse OR Dealer Existing ECC No. Registration No. Tel. No(s). 1 2 3 4 5 6 Fax No. E -Mail No. Range Division Commissionerate 7 8 9 10 11 [Please furnish the aforesaid information for each of the other such factory(ies) /warehouse(s)/dealer's premise(s] I/We hereby certify that the information given in this form is true, correct and complete in every respect and that I am authorised to sign on behalf of the applicant. Date: (Signature of the authorised person) Place: NOTE: 1. Factories, registered dealers depots or warehouses shall use separate application, as the case may be, for allotment of New ECC Number 2. Location Code is to be filled by the Range Office based on the new codes allotted by the Directorate of S & I. 3. Telephone numbers/Fax Numbers/E-mail address are to be filled if available. Acknowledgement Subject: Allotment of New Excise Control Code Number - Regarding - Your application for allotment of New ECC Number received on ____________ is hereby acknowledged. The Receipt Number is _________________ dated ___________. (Signature of the Sector Officer) with Official Seal
