Form A S P I Application for permission to avail of the special procedure relating to embroidery Name of the factory/factories....Address........ I/We......manufacturer(s) of embroidery processed at.... taluk/tehsil... district........And holders of Central Excise Registration No....dated..hereby apply to avail myself/ourselves during the...calendar month/the period beginning with ... 20. and ending with ..20.. of the special procedure contained in respect of the manufacture of the embroidery specified under the notification issued under rule 15 of the Central Excise (No. 2) Rules, 2001. 2. I/We declare that the particulars of each embroidery machine installed by me/us 3. I/We hereby agree to abide by the terms and conditions of the said procedure throughout the said period. Place: Date: Serial number allotted to the machine ( such number should be painted prominently on the machine ), Brand name and other identifying particulars of the machine Year of instillation of the machine Length of the machine in meters Maximum revolutions per minute which the machine is capable of working at Remark s (1) (2) (3) (4) (5) (6) Signature of manufacturers or his/their authorized agent(s). Countersigned ...of Central Excise Range... Circle.... Place: Date: Permission granted for calendar month/the period beginning with...and ending with.... Assistant Commissioner/ Deputy Commissioner of Central Excise Place: Date:
