FORM - HSNS
HSNS DEC- 01
Declaration of machines installed or processes undertaken for the manufacture or production of the specified goods
FORM HSNS DEC- 01
[See rule 9]
Declaration of machines installed or processes undertaken for the manufacture or production of the specified goods
1. Basic information as per Table below:
Table
|
1. |
HSNS Registration No. |
------------------------------------------------------- |
|
2. |
Legal Name |
|
|
3. |
Trade Name, if any |
|
|
4. |
Address of the Factory / Premises |
|
|
5. |
GSTIN |
|
|
6. |
Date of Filing |
DD / MM / YYYY |
2. Declaration type (Tick one)
[ ] Initial declaration (Section 9(1))
[ ] Change in declaration (Section 9(2) - Change in parameters)
[ ] New Installation / Addition / Commencement of operation of any machine or process (Section 9(3))
3. Details of specified goods manufactured as per Table below:
(Refer to Schedule I of the Act) (To be fetched from Master)
Table
|
Sl. No. |
Chapter/ Heading/ Sub-heading/ Tariff item |
Description of goods (e.g., Pan masala) |
Brand Name(s) |
|
1 |
|||
|
2 |
4. Details of machines installed (For Machine-based processes) as per Table A or B below:
(Relevant for computation of cess under Table I of Schedule II of the Act)
Table A: Existing machines
|
Sl. No. |
Make (if available) |
Model No.(if available) |
Name of manufacturer |
Machine No. |
Date of purchase |
No. of 1-b[cups]1-b (only for vertical machines) |
Gear Box Ratio of the Machine |
Revolution Per Minute of main motor |
Number of Funn els (only for horizontal machines) |
Nature of Packing (e.g., Pouch, Tin, Container) |
Weight of packages that can be packed on the machine (in grams) |
Packing capacity of each 1-c[cup]1-c or Funnel (No. of pack ages which can be packed for a particular weight of pack age in a minute 1-a[[9/8]]1-a) |
Total packing capacity of the machine for a specific weight of package to be packed in a minute (Maximum Rated Speed) [7X13] or [10 X13] |
Electricity consumption capacity of the machine per hour (KWH) |
Registration No. of the machine (To be generated at the time of submission) |
Working status (Y/N) |
|
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
(10) |
(11) |
(12) |
(13) |
(14) |
(15) |
(16) |
(17) |
Table B: Newly Added Machines (If applicable)
|
Sl.No. |
Make |
Model No. |
Name of manufacturer |
Machine No. |
Date of purchase |
No. of 1-b[cups]1-b (only for vertical machines) |
Gear Box Ratio of the Machine |
Revolution Per Minute of main motor |
Number of Funnels (only for horizontal machines) |
Nature of Packing (e.g., Pouch, Tin, Container) |
Weight of packages that can be packe d on the mach ine (in grams) |
Packing capacity of each 1-c[cup]1-c or Funn el (No. of packages which can be packed for a particular weight of package in a minute 1-a[[9/8]]1-a) |
Total packing capacity of the machine for a specific weight of package to be packed in a minute (Maximum Rated Speed) [7X13] or [10 X13] |
Electricity consumption capacity (KWH) |
Registration No. of the machi ne (To be generated at the time of submission) |
Working status (Y/N) |
|
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
(10) |
(11) |
(12) |
(13) |
(14) |
(15) |
(16) |
(17) |
|
1 |
||||||||||||||||
|
2 |
5. Change in details [For declaration under section 9(2)] as per Table below:
(Enter the serial No. of the machine and the previously given details in 1-d[at serial number 4]1-d will be auto-fetched. The details in the rows where parameters have been changed may be edited)
Table
|
Sl. No. |
Registration No. of the machine (Generated in column 16 of 1-e[Table A or Table B]1-e during submission) |
Location of installation |
No. of 1-b[cups]1-b (only for vertical machines) |
Nature of Packing (e.g., Pouch, Tin, Container) |
Gear Box Ratio of the Machine |
Revoluti on Per Minute of main motor |
Number of Funnels (only for horizontal machines) |
Weight of packages which can be packed on the machine (in grams) |
Packing capacity of each 1-c[cup]1-c or Funnel (No. of packages which can be packed for a particul ar weight of package in a minute [1-a[7/6]]1-a) |
Total packing capacity of the machine for a specific weight of package to be packed in a minute (Maximum Rated Speed) [4X10] or [8X10] |
Electricity consumption capacity of the machine per hour (KWH) |
Working status (Y/N) |
Date of change in any parameter listed. |
|
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
(10) |
(11) |
(12) |
(13) |
(14) |
6. Details of the intimation of the machines furnished to other departments as per Table below:
Table
|
Sl. No. |
Date of intimation |
Name of Govt. department / any other agency or organisation. |
Details of declaration (Proof to be uploaded as pdf) |
|
(1) |
(2) |
(3) |
(4) |
7. Disposal of packing machines (To be filed as an amendment), as per Table below:
Table
|
Sl. No. |
Registration No. of the machine |
Date of disposal |
Reason of disposal |
|
(1) |
(2) |
(3) |
(4) |
8. Details of manual processes (If applicable), as per Table below:
(Relevant for computation of Cess under Table 2 of Schedule II of the Act)
Note: This section applies only if specified goods are manufactured wholly by manual process without the aid of any machine as specified in section 5(5) of the Act.
Table
|
Sl. No. |
Description of Process |
Location / Section within Factory |
Nature of Packing (e.g., Pouch, Tin, Container) |
Weight of Specified Goods Packed (in Grams) |
Average Daily Production Capacity (Units) |
Date of Commencement of Process |
|
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
|
1 |
||||||
|
2 |
9. Documents uploaded (Maximum 5 documents, 2mb each (pdf))
1. [ ] Technical specification sheet of machines (Manufacturer's manual)
2. [ ] Certificate from Chartered Engineer (certifying speed and capacity of the machines)
3. [ ] Layout plan of the factory indicating machine locations
4. [ ] Other Department Intimation Declaration
5. [ ] Others: ____________________
10. Verification
I, ___________________________ (Name of Authorised Signatory), son/daughter of ___________________, 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 understand that any false declaration is liable for penal action under Chapter VI of the Health Security se National Security Cess Act, 2025.
Place: _________________
Date: __________________
Name: ___________________________
Designation: _____________________
1-a. Inserted (w.e.f. 01-02-2026) vide Notification No. 02/2026-HSNS Cess dated 30-01-2026
1-b. Substituted (w.e.f. 01-02-2026) vide Notification No. 02/2026-HSNS Cess dated 30-01-2026 for "tracks"
1-c. Substituted (w.e.f. 01-02-2026) vide Notification No. 02/2026-HSNS Cess dated 30-01-2026 for "track"
1-d. Substituted (w.e.f. 01-02-2026) vide Notification No. 02/2026-HSNS Cess dated 30-01-2026 for "table 4"
1-e. Substituted (w.e.f. 01-02-2026) vide Notification No. 02/2026-HSNS Cess dated 30-01-2026 for "Table III or Table IV"
Act
-
THE HEALTH SECURITY SE NATIONAL SECURITY CESS ACT, 2025
Rules
-
Health Security Se National Security Cess Rules, 2026
Notifications
-
Health Security se National Security Cess
