application for transfer of cenvat credit, rule 10

you have to approach the juridictional AC with your details in writing, who will ask u to submit the requisite details and documents for transfer and onward submission to target excise department, 

on the case merit he may or may not depute officer for physical recording and verification of the transfer related to documents submitted by you.

there is no prescribed format but the A/C or D/C as the case maybe, would ask to submit the records as they deem fit for safeguard of revenue.