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KERALA COMMERCIAL TAXES DEPARTMENT


e-Consignment Declaration
Form No.8F
[See Rule 66 (6)]

Vehicle Type

: TEMPO

Token Number

: 32090219482/2014-15/2654

Vehicle Number

TN796601

Driver Address

: TAMILNADU

Driver Name

GANESHKUMAR

Expecting Check Post : KUPPANDAGOUNDANUR AT


OZHALAPATHY - CT CHECK POST

Driver License No

00038/2017

Expecting Date

: 28-Jan-2015

VIJAYAKUMAR, TAMILNADU

Vehicle Permit No

Owner Name & Address :

1) Consignor : 33375663524 ,
TEXCONES,2/153/6, PERIYASAMIYAPURAM
ROAD,CHINNAKOVILANKULAM
VILLAGE,PERIYAKOVILANKULAM P.O.,
SANKARANKOVIL T.K.

Consignee/Delivery : 32090219482 , PRECOT


MERIDIAN LIMITED,A UNIT
KANJIKODE,PALAKKAD

Nature of Transaction : Inter-State Purchase


Sl.
Invoice No Invoice Date
No
1

10002

10003

Commodity

PACKING
MATERIALS
PACKING
27-Jan-2015
MATERIALS
27-Jan-2015

Quantity

Weight

Value(in Rs)

17500 NOS

805 KGs

43,452.00

10000 NOS

460 KGs

24,480.00

I , the consigner/consignee/representative hereby declare that the information


furnished above are correct and complete.

Date : 28-Jan-2015 10:09 AM

Name & Signature


:

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