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Sl. No.	Description	Input
(1)	(2)	(3)
1.	Legal Name of the Business (As per PAN) *
2.	Goods and Services Tax Identification Number (GSTIN) (if any) (Enter GSTIN of the place where machines are located at Principal Place of Business/ Additional Place of Business)
3.	Central Excise Registration Number (if any)
4.	Email Address*
5.	Mobile Number*

1, 4 & 5*- Mandatory Fields

Part - B (Business and process details) as per Table below:

1. BUSINESS DETAILS

Table

Sl. No.	Description	Input
(1)	(2)	(3)
1.	Trade Name (if any)
2.	Constitution of Business (Select Appropriate)	Proprietorship Partnership Private Limited Company Public Limited Company LLP HUF Others
3.	Date of Commencement of Business	[DD/MM/YYYY]
4.	Date on which liability to register arises	[DD/MM/YYYY]

2. ADDRESS OF MANUFACTURING PREMISES (FACTORY) AS PER TABLE BELOW:

Table

Sl. No.	Description	Input
(1)	(2)	(3)
1.	Address Details
	Building No./ Flat No.
	Name of Premises/Building
	Road/Street/Lane
	City/District
	State/Union Territory [Drop Down]
	PIN Code
	Boundaries of the premises to be Registered (North/South/East/West)
2.	Jurisdiction (Commissionerate/Division/Range) [Drop Down]
3.	Nature of Possession of Premises	Owned Leased Rented Consent Shared

3. CATEGORIZATION OF TAXABLE ACTIVITY AS PER TABLE BELOW:

Based on section 4 and Schedule II of the HSNS Cess Act, 2025

Table

Sl. No.	Description	Input
(1)	(2)	(3)
1.	Category of taxable person	Wholly or partly machine-based process (Table 1 of Schedule II of the Act) Wholly Manual Process (Table 2 of Schedule II of the Act)
2.	Nature of control over machines/process	Owner Lessee Operator/Controller Job Worker
3.	Description of specified goods (As per Schedule I)	Pan Masala (2106 90 20) Other Notified Goods

4. Details of Promoter /Partners / Directors as per Table below:

Table

Sl. No.	Description	Details
(1)	(2)	(3)
1.	Personal Details
	Name of Person
	Designation (Proprietor/Partner/Director/Karta)
	Permanent Account Number (PAN)
	Residential Address
	Mobile Number & Email
	Photo Upload

5. Details of authorised signatory as per Table below:

Table

Sl. No.	Description	Details
(1)	(2)	(3)
1.	Personal Details
	Name of Person
	Designation (Proprietor/Partner/Director/Karta)
	Permanent Account Number (PAN)
	Residential Address
	Mobile Number & Email
	Photo Upload	[Upload Button]

6. Bank account details as per Table below:

Table

Sl. No.	Description	Input
(1)	(2)	(3)
1.	Bank Account
	Account Number	[Number]
	Type of account [Current/Savings/CC]
	IFSC code	[Text]
	Bank name and Branch	[Text]

Verification

I ___________________________ (Name of authorised signatory) hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. I undertake to comply with the provisions of the Health Security se National Security Cess Act, 2025 and the rules made thereunder.

Place:‐---‐‐------------------------------

Date:---‐‐---------------------------------

Designation:---‐‐---------------------

List of Documents to be Uploaded (maximum 5 no. of documents each 2 mb(pdf/jpeg))

Proof of Constitution of business: (Partnership Deed, Certificate of Incorporation, etc.) (pdf)
Proof of address of premises: (Property Tax Receipt, Electricity Bill, Rent/Lease Agreement) (pdf)
Photo of Promoters/Partners/Directors (jpeg)
Proof of bank account: (Cancelled cheque or first page of passbook) (pdf)
Authorisation letter: For the authorised signatory (pdf)

Rules

Health Security Se National Security Cess Rules, 2026
- Rule 4 - Application for registration

FORM - HSNS

FORM HSNS REG-01

Application for Registration

Rules

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