ORDERED ON: PREPAID

JIT Surat
DEL/LPN
F3 Tax invoice/Bill of Supply/Cash memo
www.PaytmMall.com Number: 24B0009635402322 Date: 05-11-2018 PaytmMall Order Id: 6456321671
Weight: 350 gms

XPRESSBEES - PREPAID Sold By: KRISHNAM FASHION

26, Paramhans Society, Near Patidar Vadi,

*1227189522807* AWB #: 1227189522807

Ambatalavadi, Katargam, Surat. Pin Code- 395004
SURAT, Gujarat - 395004
PAN: GDCPS9589D
GSTIN: 24GDCPS9589D1ZZ
SHIP TO:
AMANJIT SINGH Shipping Address: AMANJIT SINGH Billing Address: AMANJIT SINGH
99, SFS FLATS, 99, SFS FLATS,
99, SFS FLATS,
SIDHARTHA ENCLAVE, ASHRAM SIDHARTHA ENCLAVE, ASHRAM
SIDHARTHA ENCLAVE, ASHRAM
CITY: DELHI DELHI,DELHI-110014 DELHI,DELHI-110014
STATE: DELHI Place of supply : DELHI (07)
PIN: 110014

OB : FORM 402 Required

ITEM QTY. PRICE (INR) TAX RATE & TYPE TAX AMOUNT TOTAL AMOUNT
*4710661210*

If undelivered, return to:

KRISHNAM FASHION (96354) (INR) (INR)
SHIPMENT # 4710661210
ORDER # 6456321671

26, Paramhans Society, Near Patidar Vadi,

Ambatalavadi, Katargam, Surat. Pin Code- 395004 Krishnam Fashion Orange Printed 1 618.1 5% IGST 30.9 649
CITY: SURAT
STATE: Gujarat Georgette Saree
PIN: 395004 HSN Code :5007
GSTIN: 24GDCPS9589D1ZZ TRUMP ORANGE

Grand Total 1 618.1 30.9 649

Total Amount in Words: Six Hundred Forty Nine Rupees Only

Declaration:
We declare that this invoice shows the actual price of the goods * This is a computer generated invoice and does not require a
described above and that all particulars are true and correct. The goods physical signature
sold are intended for end user consumption and not for resale.

Customer Acknowledgement:
I AMANJIT SINGH confirm that the said products are being purchased for my internal/personal consumption and not for re-sale.
 FORM 402

(See rule 51)

Declaration under section 68 of the Gujarat Value Added Tax Act, 2003

(For movement of goods within the State or goods moving outside the State)

To,

The officer in charge

Check post .......

(1) Place from which goods are dispatched < 26 Paramhans society near patidar vadi Ambatalavadi
katargam surat 395004 > District _______________
(2) Place to which goods are dispatched < 99, Sfs Flats,,sidhartha Enclave, Ashram,delhi, Delhi-
110014 > District ___________
(3) Details of goods invoice No < 1 > Date < 05-11-2018 >
(4) Consignor s details :

Name Krishnam Fashion Registration 24222705333

Certificate No
Address 26 Paramhans Society Near Patidar Vadi Date
Ambatalavadi Katargam Surat 395004
Telephone 9825984020 Cst Registration 24222705333
No.
Fax No. Date

(5) Nature of Transaction :

1: Inter state sale 2: Transfer of documents of title
3: Depot Transfer 4: Consignment to Branch/Agent
5: For Job works/Works contract
6: Any Other

(6) Consignee s details :-

Name Amanjit Singh State Delhi

Address 99, Sfs Flats,,sidhartha Enclave, Ashram, Registration
delhi, Delhi- 110014 Certificate No
Date
Telephone 8882220444 Cst Registration
No.
Fax No. Date

Consigned Value Rs. < 649 >

Sr. No. Description Of Goods Commodity Unit Quantity Rate Of Tax Value
Code
1 Krishnam Fashion Orange 1 0 649
Printed Georgette Saree
(7) Transporter s Details : (a) Name

(b) Address

(c) Owner/ Partner s Name

(8) Vehicle No ____________________ L.R.No. ____________________ Date _________________

(9) Driver s Details (a) Name

(b) Address

(c) Driving License No.

(d) License issuing State

(e) Driver s Signature

(10) Name of the Address of person in charge of goods _________________________

Seal

Place : _____________________ Signature :___________________

Date : _____________________ Designation : ________________

For Commercial Tax Department/Check post

Entry No. Reason Of Abnormal Stoppage Result If Any
Vehicle Date Time
Arrival
Depart

Date __________________ Signature ________________ Designation _______________