APPLICATION TO AVAIL THE FACILITY OF FILING EXCISE RETURNS ELECTRONICALLY 1. Name of Assessee. 2. Excise Control Code (15 digit Excise Registration No.) 3. Category of Excise return presently filed: ER1/ER-2/ER-3/Dealer Return. 4. E-mail Address: 5. Postal Address: (Please give a confidential e-mail address and the postal address to which the User Login ID, Password and the present Location Code of the jurisdictional range can be sent) The 15-digit ECC will serve as User ID. 6. I/We request that I/We may be permitted to file my Excise Return electronically. I/We declare that I/We satisfy the conditions of Trade Notice No...Dated..and shall observe the instructions given therein. I/We undertake to indicate my/our 15-digit ECC in every challan used by me/us for remitting Excise duty in Banks. If any difficulty is faced in filing the return electronically and getting an acknowledgement from the computer before the due date, I/We shall file manual returns as was done hitherto. Date: Place: Name and signature of the authorized person