RETAIL INVOICE

INVOICE NUMBER :S22D33/16-17/652 INVOICE DATE :11-JUN-2016

SELLER BUYER
WEGA LIFESTYLE PVT LTD SHADAB NASEEM
S-8/415 A-12, RAZA COLONY, M.A ROAD, KHAJURI
PLOT NO. 3, LOWER GROUND FLOOR, SECTOR-8, DWARKA,
CITY VARANASI / STATE UTTAR PRADESH
CITY NEW DELHI / STATE DELHI
PIN 221002
PIN 110077 MOBILE 9335339693
COMPANY'S VAT TIN : 07686954384

COMPANY'S CST NO. : 07686954384

DISPATCHED VIA JV EXP DISPATCH DOC. NO. (AWB) 801942557

S.NO. ITEM DESCRIPTION QTY RATE AMOUNT

1 DAMOCHI TAN LOAFERS
ATTRIBUTE : SIZE - 7
ORDER NO.: 13693253520
1 499.0 499.0
SUBORDER NO.: 17141406006

TOTAL( INCLUSIVE OF TAXES) Rs. 499

AMOUNT IN WORDS : INDIAN RUPEES FOUR HUNDRED NINETY NINE ONLY

DECLARATION
We declare that this invoice shows actual price of the goods described inclusive of taxes and that all particulars are true and correct.
CUSTOMER ACKNOWLEDGEMENT
I SHADAB NASEEM hereby confirm that the above said product/s are being purchased for my internal / personal consumption and not for re-sale.
THIS IS A COMPUTER GENERATED INVOICE AND DOES NOT REQUIRE SIGNATURE

1
 FORM - XVII
Department of Commercial Taxes, Government of Uttar Pradesh
[See sub-rule (9)(a) of Rule-38 of the UPVAT Rules, 2007]
Declaration by the consigner to be obtained by a transporter, carrier or forwarding agent, railway container
contractor
Declaration No Date : 11-Jun-2016

Name & Address of WEGA LIFESTYLE PVT LTD

Consigner Plot No. 3, Lower Ground Floor, Sector-8, Dwarka,

Phone No. if any 9555136999

T.I.N. 07686954384

Name & Address of Shadab Naseem

Consignee S-8/415 A-12, Raza Colony, M.A Road, Khajuri

Phone No. if any 9335339693

T.I.N.
SI.No. Detail of goods received for transportation Number
No. and date of tax invoice/sale invoice/bill/cash
1. S22D33/16-17/652
memo/Purchase Invoice/Transfer Challan-
2. Description of goods Damochi Tan Loafers (Size: 7)
3. No. of packets / bags / case 1
4. Weight / measurement
5. Value of goods 499
6. Goods Receipt no.& date 801942557
Name and Address of
transporter, carrier or
forwarding agent JV_EXP
railway container
contractor.
Phone No. if any
Service Provider Number
I..............................................................s/o,d/o,w/o................................................................................., (status)
...................... of the business, do hereby declare that particulars furnished above are true to the best of my
knowledge.
Signature, Name & Status of the Authorized Person
Seal of Consigner
Date
FORM - XVIII
Department of Commercial Taxes, Government of Uttar Pradesh
[See sub-rule (9)(a) of Rule-38 of the UPVAT Rules, 2008]
Declaration by the consigner to be obtained by a transporter, carrier or forwarding agent, railway container
contractor
Declaration No Date :11-Jun-2016

Name & Address of Shadab Naseem

Consignee S-8/415 A-12, Raza Colony, M.A Road, Khajuri
2
 Phone No. if any 9335339693
T.I.N.

Name & Address of WEGA LIFESTYLE PVT LTD

Consigner Plot No. 3, Lower Ground Floor, Sector-8, Dwarka,

Phone No. if any 9555136999

T.I.N. 07686954384
SI.No. Detail of goods received for transportation Number
No. and date of tax invoice/sale invoice/bill/cash
1. S22D33/16-17/652
memo/Purchase Invoice/Transfer Challan-
2. Description of goods Damochi Tan Loafers (Size: 7)
3. No. of packets / bags / case 1
4. Weight / measurement
5. Value of goods 499
6. Goods Receipt no.& date 801942557
Name and Address of
transporter, carrier or
forwarding agent JV_EXP
railway container
contractor.
Phone No. if any
Service Provider Number
I..............................................................s/o,d/o,w/o................................................................................., (status)
...................... of the business, do hereby declare that particulars furnished above are true to the best of my
knowledge.
Signature, Name & Status of the Authorized Person
Seal of Consigner
Date