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)
	- Name of the Applicant(s) _________________________________________________ 
	
	 
	- Permanent Account Number _________________________________________________
(Issued by the Income Tax Department) (Attested copy to be enclosed) 
	 
	- 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) 
_________________________ 
	
	 
	- 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:
Place: 
(Signature of the authorised person)
NOTE:
	- Factories, registered dealers depots or warehouses shall use separate 
application, as the case may be, for allotment of New ECC Number
	
	 
	- Location Code is to be filled by the Range Office based on the new codes 
allotted by the Directorate of S & I.
	
	 
	- 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