FORM XXI
(See sub-rule (9) of rule 31)
Register of unused Certificates for Import surrendered by unregistered dealers or persons to be maintained by Assistant Commissioner
Date
Name and address of person surrendering forms
Total no. of forms
Serial No.
Date on which Certificate was issued
Serial No. in Register in Form XX
Reason for return of forms
Signature of Assistant Commissioner
Remarkes regarding details of destruction or disposal of Certificate along with dated signature of Assistant Commissioner
To