Sch 1 amended by SLI No 151 of 2012, reg 3 and Sch 2 item 2, by substituting table items 8 and 9, effective 1 July 2012. Table items 8 and 9 formerly read:
Sch 1 amended by SLI No 195 of 2011, reg 3 and Sch 1 item 5, by inserting table items 8 and 9, applicable in relation to circumstances that first exist on or after 1 December 2011.
Sch 1 substituted by SLI No 174 of 2006, reg 3 and Sch 1 item 17, effective 1 July 2006. Sch 1 formerly read:
Form 1
(regulation
4
)
Tobacco leaf producer's book
AUSTRALIAN EXCISE
Tobacco Leaf Producer's Book
Name of Producer
Place
Registration No.
|
Date
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Extent of area on which leaf is grown in hectares
|
Quantity of cured tobacco leaf produced in kilo-grammes
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Date
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Quantity of cured tobacco leaf removed
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To whom delivered
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Pkgs
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kg
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Name
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Address
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Form 2
(regulation
6
)
Tobacco producer's return for twelve months ended 31st December, 20
AUSTRALIAN EXCISE
Tobacco Producer's Return for Twelve Months ended 31st December, 20
.
Name of Producer:
Postal address:
The total area from which Tobacco Leaf was harvested by me during the twelve months ended 31st December, 20
was
-
Hectares:
Where situated:
Cured Leaf
-
kg
(a) On hand at 1st January, 20
, as shown on my last return
.
Obtained from crop harvested between 1st January, 20, and 31st
December, 20
.
Returned as unsaleable or for any other reason
[
give particulars on a separate sheet
]
.
Total (
a
)
.
kg
(b) Total quantity removed between 1st January, 20
and 31st December,
20
, including leaf rehandled, as shown below
.
Leaf destroyed (
quote authority and method of destruction
)
.
Balance on hand on farm on 31st December, 20
.
Total (
b
)
.
The difference of
kg between the total of (
a
) and (
b
) is accounted for as follows:
(Omit if totals agree)
DETAILS OF TOBACCO LEAF REMOVED SHOWING PARTICULARS OF EACH CONSIGNMENT
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Date
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Quantity
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Name and Address of Dealer or Manufacturer to whom Sold or Delivered
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kg |
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The area which I have planted or proposed to plant with Tobacco which will be harvested during the year 20
is
hectares situated at
I hereby declare that this return is a true statement of the particulars mentioned therein for the twelve months ended 31st December, 20
.
(Signature of Producer)
Declared before me at this day of 20
.
(Signature of Person taking Declaration)
Form 3
(regulation
8
)
Tobacco leaf dealer's book
AUSTRALIAN EXCISE
Tobacco Leaf Dealer's Book
Name of Dealer Place
|
Date
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Tobacco Leaf Bought
|
Date
|
Tobacco Leaf Sold
|
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Australian
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Imported
|
From whom Bought
|
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Australian
|
Imported
|
To whom Sold
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Address of Buyer
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kg |
kg |
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pkgs |
kg |
pkgs |
kg |
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Form 4
(regulation
10
)
Tobacco leaf dealer's return
AUSTRALIAN EXCISE
Tobacco Leaf Dealer's Return
Name of Dealer Place
|
Quantity of Tobacco Leaf Bought
|
From whom
|
Quantity of Tobacco Leaf Sold
|
To whom
|
Quantity of Tobacco Leaf in Hand
|
|
Australian
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Imported
|
|
Australian
|
Imported
|
|
Australian
|
Imported
|
| |
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pkgs |
kg |
pkgs |
kg |
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hereby declare that the above return contains a true statement of the particulars mentioned therein for the quarter ended day of
last past.
(Signed)
Declared at this day of 20
, before me.
(Signed)
(Description of person taking declaration)
Form 6
(regulation
34
)
Application for delivery of Australian leaf or Australian manufactured tobacco for agricultural, horticultural or sheep-wash purposes
AUSTRALIAN EXCISE
Application for Delivery of Australian Leaf or Australian Manufactured Tobacco for Agricultural, Horticultural or Sheep-wash Purposes
To the Collector,
I (or we)
request permission to mix with kg weight of Australian tobacco leaf (or Australian manufactured tobacco), now stored in to be afterwards used at for the purpose of
Dated the day of
20
.
Applicant
Approved
-
Collector
20.
Form 19
(regulation
143
)
Application for delivery of certain spirits for industrial or scientific purposes
AUSTRALIAN EXCISE
Application for delivery of spirits, not matured in wood for 2 years, for industrial or scientific purposes
Address
.
Date
To the Collector
I request your permission upon payment of duty to take delivery of spirits not matured by storage in wood for a period of not less than two years, to be used by me in the making of
(or for sale to chemists or manufacturers for use in the making or compounding of ) (1).
I enclose a security that I will use the spirits for no other purposes.
I undertake to keep a book showing the quantities of such spirits used in the making of
, (and the quantities sold to chemists or manufacturers for the making of
) (1) and that the book will be balanced monthly and kept ready for inspection at any time by an officer of Excise.
(1) Words in parentheses to be inserted only when the applicant desires to sell small quantities to chemists or others in use in the manufacture of medicines or other items mentioned in form of security.
Form 21
(regulation
148
)
Form of record to be kept by users of Australian spirits, not matured in wood for two years, delivered under item 2(M) of the Excise Tariff 1901
AUSTRALIAN EXCISE
Form of record to be kept by users of Australian spirits, not matured in wood for two years, delivered under item 2(M) of the Excise Tariff 1901
|
Received
|
How disposed of
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Spirits Received
|
Spirits used
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Sold
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Quantity
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Article in preparation of which spirits are to be used
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Date
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Number of warrant
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Product in litres
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Percentage by volume of alcohol
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Alcohol in litres
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Date
|
Product in litres
|
Percentage by volume of alcohol
|
Alcohol in litres
|
Article in preparation of which spirits have been used
|
Date
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Name of purchaser
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Product in litres
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Percentage by volume of alcohol
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Alcohol in litres
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Balance on hand |
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I declare that the foregoing entries relating to the month of, 20
, fully set forth all the matters required by law and that the same are true in every particular.
(Signature of Manufacturer)
Declared at this day of
, 20
before me
-
(Description of person taking declaration)
Form 23
(regulation
178
)
Declaration of manufacturer to return of excisable goods
AUSTRALIAN EXCISE
Declaration of Manufacturer to Return of Excisable Goods
I declare that the particulars set out in this return are true, and that nothing has been omitted therefrom which ought to have been set out therein.
Manufacturer
Declared at this day of 20
, before me
J.P., or Officer
Form 24
(regulation
182
)
Appointment of person to make declaration on behalf of manufacturer, brewer, distiller, dealer, or producer
AUSTRALIAN EXCISE
Appointment of person to make declaration on behalf of manufacturer, brewer, distiller, dealer, or producer
I/We* appoint (
insert name of person to be appointed
) to make, on my/our* behalf, all declarations required by regulations for the time being in force under (
insert short title of Act
) to be made by me/us*; and
I/We* declare that all declarations made by (
insert name of person to be appointed
) under this appointment, shall be taken to have been made with my/our* knowledge and consent, and that I/we* shall be liable to all pecuniary penalties in respect of those declarations to the same extent as if I/we* had made those declarations myself/ourselves*.
Dated at
this
day of
20
.
(Signature of Manufacturer, or Brewer, or Distiller, or Dealer, or Producer)
Signature of Appointee
To the Collector
*Omit whichever is inapplicable
Form 25
(regulation
186
)
Return of ship's stores or aircraft's stores
RETURN OF SHIP'S STORES OR AIRCRAFT'S STORES
Ship (
or
Aircraft) From Master (
or
Pilot)
Principal agent
Duty payable at
Arrived at the port of on the day of, 20
.
List of Goods liable to Excise Duties
|
Description of Goods
|
Quantity consumed in Australia
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|
I hereby declare that the particulars shown in this form are a true and accurate statement of all ship's stores (
or
aircraft's stores) liable to Excise duties consumed on board the abovementioned ship (
or
aircraft) in Australia.
Master (
or
Pilot)
Declared at before me this day of
, 20
.
Collector
Form 39
(section
185
)
Authority to agent to sign declarations
AUSTRALIAN EXCISE
Authority to Agent to Sign Declarations
(
a
) hereby authorizes (
b
) (whose signature appears below) to sign as its agent forms containing declarations required under the
Excise Regulations 1925
.
Dated at the
day of
20
.
In witness whereof the Common Seal of the (
c
) was affixed hereto in the presence of
To the Collector
Signature of person authorized
(a) Here insert name of principal
(b) Here insert name of person authorized
(c) Here insert ``Company,
'
'
``Corporation,
'
'
or as the case may be
Form 40
(regulation
119
)
Security
-
spirit for use in public hospitals
COMMONWEALTH OF AUSTRALIA
Excise Act 1901
SECURITY
SPIRIT FOR USE IN PUBLIC HOSPITALS
By this security the subscribers are, under the
Excise Act 1901
, bound to the CEO (as defined in that Act) in the sum of subject only to this condition that if all excisable spirit which is from time to time during the continuance of this security delivered to under Excise Tariff Item is dealt with in accordance with the
Excise Act 1901
and any amendment thereof or any Act passed in substitution therefor and the Regulations for the time being in force thereunder, then this security shall be thereby discharged.
[#_1]
Insert whether ``Pure Australian Standard Brandy
'
'
, ``Australian Blended Brandy
'
'
, ``Australian Standard Malt Whisky
'
'
, ``Australian Blended Whisky
'
'
, or ``Australian Standard Rum
'
'
.
Dated at
the
day of 20
.
|
Name and Descriptions of Subscribers
|
Signature of Subscribers
|
Signature and Addresses of Witnesses
|
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* Note - If liability is not intended to be joint and several and for the full amount here state what is intended as, for example, thus
-
``The liability of the subscribers is joint only'', or ``The liability of
[
mentioning subscriber
] is limited to
[
here state amount of limit of or mode of ascertaining limit
].
'
'
Form 41
(regulation
124
)
Return showing particulars of Australian spirit received and disposed of by hospital during the half-year ended, 20
.
AUSTRALIAN EXCISE
Return showing particulars of Australian spirit received and disposed of by Hospital during the half-year ended, 20
.
|
Date
|
|
Date
|
|
|
20
|
|
Spirit received
|
20
|
|
Spirit disposed of
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litres |
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litres |
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|
Balance on hand at end of previous half year.
Receipts during half-year to which return relates
-
From..........
From..........
From..........
From..........
From.......... |
|
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|
Distributions to other hospitals
-
To..........
To..........
Used
-
For..........
For..........
For..........
For..........
Balance on hand at end of half-year to which return relates.......... |
|
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|
Total....... |
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Total....... |
|
I, hereby declare that the above return contains a true statement of the particulars mentioned therein for the half-year ended
, 20
.
(Signature of Declarant)
Declared at before me this day of
, 20
.
(Description of person taking declaration)
Form 46
(regulation
125B
)
Record of spirits used in the manufacture of medicinal preparations
AUSTRALIAN EXCISE
Excise Act 1901
RECORD OF SPIRITS USED IN THE MANUFACTURE OF MEDICINAL PREPARATIONS
|
|
How disposed of
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|
Date
|
Name of preparation
|
Product in litres
|
Percentage by volume of alcohol
|
Alcohol in litres
|
To whom delivered
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Place
|
Excise Permit Number
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I declare that the foregoing entries relating to the month of, 20
, fully set forth all the matters required by law and that the same are true in every particular.
(Signature of Manufacturer)
Declared at
this
day of, 20
.
before me -
(Description of person taking declaration)
Form 47
(regulation
125C
)
Security
-
spirit used in the manufacture of medicinal preparations for use in public hospitals
COMMONWEALTH OF AUSTRALIA
Excise Act 1901
SECURITY
SPIRIT USED IN THE MANUFACTURE OF MEDICINAL PREPARATIONS FOR USE IN PUBLIC HOSPITALS
By this security the subscribers are, pursuant to the
Excise Act 1901
, bound to the CEO (as defined in that Act) in the sum of subject only to this condition that if all medicinal preparations containing spirit entered under Excise Tariff Item 2 (Q) and received by for distribution to Public Hospitals are from time to time during the continuance of this security delivered by only to Public Hospitals and that the provisions of the
Excise Act 1901
are, during the continuance of this security, complied with by then this security shall be thereby discharged.
Dated at the day of 20
.
|
Name and Descriptions of Subscribers
|
Signature of Subscribers
|
Signature and Addresses of Witnesses
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NOTE
-
If liability is not intended to be joint and several and for the full amount here state what is intended as, for example, thus- ``The liability of the subscribers is joint only'' or ``The liability of
[
mentioning subscriber
] is limited to
[
here state amount of limit of or mode of ascertaining limit
].''
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