15^th September, 2003.

Quarterly Return under Rule 7 of the CENVAT Credit Rules, 2002

for the Registered Dealers

{See sub-rule (6) of rule 7}

Return for the  quarter ending -----------------

1.      Name of the first stage/second stage dealer :

2.      Excise registration number :

3.      Address :

4.      Particulars of invoices issued by first stage/second stage dealer :

5.      Particulars of the documents based on which the credit is passed on:

* Give details with respect to the item with maximum duty covered by the document

Place:

Date:

Signature of the registered person or the authorised signatory

Name in capital letters
Designation
Seal of the registered dealer.