AMC TAX INVOICE

Issued under GST Invoice Rules

Original : For Recipient
Duplicate : For Supplier

TATA MOTORS LIMITED Dealer Invoice No : HSSNAG1718000029 Chassis No : MAT395024G0P11093

MUMBAI CORP. ADMIN. Dealer Invoice Date : 15/02/2018 Vehicle Regn. No : MH40BG0645
MUMBAI Job Card No. : JC-HiSaaS-NG-1718-000489 Kms : 40376
MH Job Card Date : 30/09/2017 AMC # : 401357510010
India Service Request Type : AMC - TM SAP Claim No: 1700253993
400068 Payment Method : AMC Claim Number:
GSTIN : 27AAACT2727Q1ZW Dealer GSTIN : 27AIUPG1613M2ZX Authorization Req No:
Place of Supply:MUMBAI Organization : HIGHWAY SALES AND Authorization Status:
SERVICES
Claim Submission Dt: 02/10/2017
05:15:34 PM

Total Disc Disc Taxable SGST/UTGS

Part #/Job CGST IGST
S No HSN/SAC Particulars Qty Rate Amt Amt % T Total Amt
No Amt
Rate% Amt Rate Amt Rate% Amt
SCHEDULED
SERVICE
LABOUR - 100.
1 998714 SLSTK40 1 999.9 999.9 0.00 0.00 9.00 0.00 9.00 0.00 0.00 0.00 0.00
40,000KM - 00
SINGLE AXLE
TRUCK (AMC)
FUEL WATER
2786091199 SEPARATOR 1302.0 111.3 111.3
2 8421.29.00 1 1302.02 0.00 5.00 1236.92 9.00 9.00 0.00 0.00 1,459.56
09 ASSY SPIN ON 2 2 2
ELEMEN
2786079899
3 8421.21.90 FILTER FUEL 1 1118.3 1118.3 0.00 5.00 1062.39 9.00 95.62 9.00 95.62 0.00 0.00 1,253.63
67
ASSY OIL
2527181301 FILTER 1016.0
4 8421.29.00 1 1016.05 0.00 5.00 965.25 9.00 86.87 9.00 86.87 0.00 0.00 1,138.99
45 ELEMENT 5
SPINON BS4
A/FILTER
2786091399 1261.5 107.8 107.8
5 8421.39.90 ELEMENT 1 1261.54 0.00 5.00 1198.46 9.00 9.00 0.00 0.00 1,414.18
08 4 6 6
PRIMARY BS4
CASTROL RX
AMCOILCA
TURBO TC 45600 100.
6 2710.19.80 STRX15W4 16 285 0.00 0.00 9.00 0.00 9.00 0.00 0.00 0.00 0.00
15W40 (CI4) 00 00
0
(AMC)

@ 9% CGST on Parts: 401.67

@ 9% SGST on Parts: 401.67
Taxable Amount : 4,463.02
CGST Tax Amount: 401.67
SGST Tax Amount: 401.67
UTGST Tax Amount: 0.00
IGST Tax Amount: 0.00
Total Tax Amount: 803.34
Rupees Five Thousand Two Hundred Sixty Six and paise Thirty Six Only. Grand Total : 5,266.36

Tax Payable under Reverse Charge - No

Terms and Conditions: E. & O. E
1) Goods once sold will not be taken back or exchanged except as required by law.
2) Only the courts of shall have jurisdiction in any proceedings relating to this contract.
3) I/we hereby certify that my/our Registration Certificate under the is in force on the date on which the sale of the goods specified in this bill /
cash memorandum is made by me/us and that the transaction of sale covered by this bill / cash memorandum has been effected by me/us in the
regular course of my / our business
Vehicle / Goods received in good condition and to our satisfaction.

HEMANT Digitally signed byFor

HEMANT
OMPRAKASH OMPRAKASH GUPTA
Date: 2018.02.16
GUPTA 09:16:01 +05'30'
__________________
Authorized Signatory