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All Subject to Asansol Jurisdiction only

CONSIGNMENT NOTE

JAI BABA BASUKINATH ROADLINES


MOBILE :
(TRANSPORT CONTRACTOR & LIASION AGENTS)
B/89, P. N. Malia Road, Raniganj, Dist : Burdwan 713347
Consignment No. :
Consignor _____________________________ Consignee
____________________________________
Address_______________________________ Address
______________________________________
______________________________________
______________________________________
VAT No. _______________________________ VAT No.
______________________________________
CST No. _______________________________ CST No.
______________________________________
TRUCK No. _____________________________
FROM :
TO :

NATURE OF GOODS

Value In Rs.

WEIGHT
(MT)

Date :

FREIGHT
( PMT )

TOTAL
FREIGHT

Less : ADV.
TO PAY
Freight In Rupees :
_________________________________________________________________________
SERVICE TAX REGN. No. :
Service Tax to be paid by Consignor/ Consignee/ Transport Agency
Name Of Driver : ___________________ License No. __________________ Signature :
________________
Address : _______________________________________________________
Please receive the goods in safe condition and pay the freight mentioned above.

For Jai Baba Basukinath


Roadlines
(Authorised Signature)

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