Government of Andhra Pradesh

C.T.DEPARTMENT
(Self Printed APVAT e-Way Bill)

FORM OF WAY BILL

FORM X or FORM 600

VAT371611155635839

{See Rules 33(1)(d) & 55(1)&(4)}

Tr
Tr
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Tr
Tr
a
a
a
a
a
ORIGINAL
Way Bill No.
VA nsp - APVAT
VA nsp
VA nsp
VA ns: p371611155635839VA nsp
T3 ort
T3 ort
T3 ort
T3 ort
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DIVISION
CIRCLE : SRIKAKULAM
5 7- VIZIANAGARAM
5 71 r:
5 71 r:
5 71 r:
5 71 er:
r
No 161 : tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
up
up
up
up
1
1
1
1
v
v
v
v
v 11
1 : CTD-ON LINE SERVICE
152016
1. Office of2Issue
at 16:22:15
20 15 at
20 15 2.at Date of Issue : 1520Nov
20 5
01 55 ath
56 hi
56 hi
56 hi
1
1
1
16
i
6
6 3 of the Dealer to whom6 Waybill
6 3
3. Name and address
35 issued by the CTD6: 1 35
5
5
1
1
1
1
6: 83 DECARATION
6: 83
6: 83
6: 83
Name : M/S BISMILLA
22 9
22 9
22 9
22 9
Address : 2/5/2006,ILLISIPURAM
JN,NEAR JAGANNADHA
SWAMY TEMPLE,SRIKAKULAM,ANDHRA
:1
:1
:1
:1
PRADESH,SRIKAKULAM,532001
5
5
5
5
TTIN
T
T
T
Tr
STATE : ANDHRA
PRADESH
ra : 37408731442
ra
ra
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an
ns
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ns
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V
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4. Place
which consigned :ASRIKAKULAM
To which consigned
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37 CONSIGNOR
37 Sale
5. 1
IF THE
IS TRANSPORTING
15 37 rter THE GOODS15: After
15 37 rter
15 37 rter
5
r
r
:
:
:
:
1
1
1
1
(a) In pursuance
buyer
No 61of sale
No to6the
No 61 tir
No 61 tir
No 161 : t
tir for purpose of delivery
tir ; or
1
u
u
u
u
(b) After purchasing
v 11 them;
v 11 pa
v 11 pa
v 11 pa
v 11
p or
20 5 t
20 5 t
20 5
55 aorthgodown to an agent2for
55 th
(c) From one 2
of0the shops
sale;
0
56 hi
56 hi
1
1
1
1
16
i
i
6
6
6 3to another shop or godown 6for purpose
6 3
(d) From shop or godown
35 of storage or sale; or 6 1 35
5
5
1
1
1
1
(e) To his principal, having
them on his behalf ;6or 8
83
6: purchased
6: 83
6: 83
3
:
2
2
2
2
9
(f) To his agent for sale on2consignment
basis.
2: 9
2: 9
2: 9
:1
1
1
15
(Mark whichever is applicable)
5
5
5
Tr and address of the OtherTrDealer/Person to whom theTGoods
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VA sp
VA sp
VA nsp
V(Buyer
AT po
AT po
Name
TIN : Un Registered
T3 :oNrt SURESH KUMAR T3 ort
T3 ort
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1Address
15 7 er
15 7 er
15 37 er
15 37 rter
5 71 : eVEERAGHATTAM
r:
:
:
:
1
1
1
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 161 : t
u
u
u
u
6. Description,
and Value of vthe Goods
1
v 11Quantity
v 11 pa
v 11 pa
v 11
20 5 pat
20 15 pat
20 5 t
20 5 t
20 5
hi (Rs.)
56 hNo./Date
Commodity
Quantity
16 56 hi
16 56 hi
16Invoice
16 56 Value
16
i
3
35 36,307.00
16 358
16 3/515-11-2016
1
1
GYPSUM 16 58
00525
101.0000
6 8
NUMBER :2 3
:2 39
:2 39
:2 839
2:
2:
2:
2: 936,307.00
TOTAL
15
15
15
15
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Tr
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7. Name
an of the Owner of the goods
an vehicle or vessel by whichranthe goods are consigned : ran
a
VA sp
VA sp
VA sp
VA sp
VA nsp
or
o Transporter Name : TIRUPATHI
Tof3Transportation
T3 ort
T3No.or:t AP30W9968
T3 ort
Type
: Parcel1 T3 rte
Vehicle/Vessel
t
1
1
1
1
e
e
e
5 71 r:
5 71 r:
5 71 r:
5 71 r:
5 71 er:
Service
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
v 11 upa
v 11 upa
v 11 upa
v 11 upa
v 11
20 5: We tcertify that to the 2best
20particulars
20 5
DECLARATION
of
my/our
knowledge the
furnished here 2are
true
and
correct.
5
5
5
t
t
t
0
0
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15
Signature of the Dealer to whom Waybill issued
by the CTD
Tr
Tr
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an
an
an
a
VA sp
VA sp
VA sp
VA sp
VA nsp
T o
T o
T o
T o
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15 37 rter
15 37 rter
15 37 rter
15 37 rter
15 37 rter
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : t
u
u
u
u
v 11 pa
v 11 pa
v 11 pa
v 11 pa
v 11
20 5 t
20 5 t
20 5 t
20 5 t
20 5
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15

VAT371611155635839

Government of Andhra Pradesh

C.T.DEPARTMENT
(Self Printed APVAT e-Way Bill)

FORM OF WAY BILL

FORM X or FORM 600

VAT371611155635839

{See Rules 33(1)(d) & 55(1)&(4)}

Tr
Tr
Tr
Tr
Tr
a
a
a
a
a
DUPLICATE
Way Bill No.
VA nsp - APVAT
VA nsp
VA nsp
VA ns: p371611155635839VA nsp
T3 ort
T3 ort
T3 ort
T3 ort
T3 ort
1
1
1
1
1
e
e
e
e
DIVISION
CIRCLE : SRIKAKULAM
5 7- VIZIANAGARAM
5 71 r:
5 71 r:
5 71 r:
5 71 er:
r
No 161 : tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
up
up
up
up
1
1
1
1
v
v
v
v
v 11
1 : CTD-ON LINE SERVICE
152016
1. Office of2Issue
at 16:22:15
20 15 at
20 15 2.at Date of Issue : 1520Nov
20 5
01 55 ath
56 hi
56 hi
56 hi
1
1
1
16
i
6
6 3 of the Dealer to whom6 Waybill
6 3
3. Name and address
35 issued by the CTD6: 1 35
5
5
1
1
1
1
6: 83 DECARATION
6: 83
6: 83
6: 83
Name : M/S BISMILLA
22 9
22 9
22 9
22 9
Address : 2/5/2006,ILLISIPURAM
JN,NEAR JAGANNADHA
SWAMY TEMPLE,SRIKAKULAM,ANDHRA
:1
:1
:1
:1
PRADESH,SRIKAKULAM,532001
5
5
5
5
TTIN
T
T
T
Tr
STATE : ANDHRA
PRADESH
ra : 37408731442
ra
ra
ra
an
ns
ns
ns
ns
V
V
V
V
V
4. Place
which consigned :ASRIKAKULAM
To which consigned
po
AT pFrom
AT po
AT po : VEERAGHATTAMAT spo
or
T
rte
te
37 CONSIGNOR
37 Sale
5. 1
IF THE
IS TRANSPORTING
15 37 rter THE GOODS15: After
15 37 rter
15 37 rter
5
r
r
:
:
:
:
1
1
1
1
(a) In pursuance
buyer
No 61of sale
No to6the
No 61 tir
No 61 tir
No 161 : t
tir for purpose of delivery
tir ; or
1
u
u
u
u
(b) After purchasing
v 11 them;
v 11 pa
v 11 pa
v 11 pa
v 11
p or
20 5 t
20 5 t
20 5
55 aorthgodown to an agent2for
55 th
(c) From one 2
of0the shops
sale;
0
56 hi
56 hi
1
1
1
1
16
i
i
6
6
6 3to another shop or godown 6for purpose
6 3
(d) From shop or godown
35 of storage or sale; or 6 1 35
5
5
1
1
1
1
(e) To his principal, having
them on his behalf ;6or 8
83
6: purchased
6: 83
6: 83
3
:
2
2
2
2
9
(f) To his agent for sale on2consignment
basis.
2: 9
2: 9
2: 9
:1
1
1
15
(Mark whichever is applicable)
5
5
5
Tr and address of the OtherTrDealer/Person to whom theTGoods
Tr whom Goods were Purchased
Tr :
Name
are Consigned or from
ra
an
an
a
ns or self or Agent or Principal)V ans
VA sp
VA sp
VA nsp
V(Buyer
AT po
AT po
Name
TIN : Un Registered
T3 :oNrt SURESH KUMAR T3 ort
T3 ort
r
t
1Address
15 7 er
15 7 er
15 37 er
15 37 rter
5 71 : eVEERAGHATTAM
r:
:
:
:
1
1
1
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 161 : t
u
u
u
u
6. Description,
and Value of vthe Goods
1
v 11Quantity
v 11 pa
v 11 pa
v 11
20 5 pat
20 15 pat
20 5 t
20 5 t
20 5
hi (Rs.)
56 hNo./Date
Commodity
Quantity
16 56 hi
16 56 hi
16Invoice
16 56 Value
16
i
3
35 36,307.00
16 358
16 3/515-11-2016
1
1
GYPSUM 16 58
00525
101.0000
6 8
NUMBER :2 3
:2 39
:2 39
:2 839
2:
2:
2:
2: 936,307.00
TOTAL
15
15
15
15
Tr
Tr
T
T
Tr
7. Name
an of the Owner of the goods
an vehicle or vessel by whichranthe goods are consigned : ran
a
VA sp
VA sp
VA sp
VA sp
VA nsp
or
o Transporter Name : TIRUPATHI
Tof3Transportation
T3 ort
T3No.or:t AP30W9968
T3 ort
Type
: Parcel1 T3 rte
Vehicle/Vessel
t
1
1
1
1
e
e
e
5 71 r:
5 71 r:
5 71 r:
5 71 r:
5 71 er:
Service
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
v 11 upa
v 11 upa
v 11 upa
v 11 upa
v 11
20 5: We tcertify that to the 2best
20particulars
20 5
DECLARATION
of
my/our
knowledge the
furnished here 2are
true
and
correct.
5
5
5
t
t
t
0
0
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15
Signature of the Dealer to whom Waybill issued
by the CTD
Tr
Tr
Tr
Tr
Tr
an
an
an
an
a
VA sp
VA sp
VA sp
VA sp
VA nsp
T o
T o
T o
T o
T o
15 37 rter
15 37 rter
15 37 rter
15 37 rter
15 37 rter
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : t
u
u
u
u
v 11 pa
v 11 pa
v 11 pa
v 11 pa
v 11
20 5 t
20 5 t
20 5 t
20 5 t
20 5
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15

VAT371611155635839

Government of Andhra Pradesh

C.T.DEPARTMENT
(Self Printed APVAT e-Way Bill)

FORM OF WAY BILL

FORM X or FORM 600

VAT371611155635839

{See Rules 33(1)(d) & 55(1)&(4)}

Tr
Tr
Tr
Tr
Tr
a
a
a
a
a
TRIPLICATE
Way Bill No.
VA nsp - APVAT
VA nsp
VA nsp
VA ns: p371611155635839VA nsp
T3 ort
T3 ort
T3 ort
T3 ort
T3 ort
1
1
1
1
1
e
e
e
e
DIVISION
CIRCLE : SRIKAKULAM
5 7- VIZIANAGARAM
5 71 r:
5 71 r:
5 71 r:
5 71 er:
r
No 161 : tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
up
up
up
up
1
1
1
1
v
v
v
v
v 11
1 : CTD-ON LINE SERVICE
152016
1. Office of2Issue
at 16:22:15
20 15 at
20 15 2.at Date of Issue : 1520Nov
20 5
01 55 ath
56 hi
56 hi
56 hi
1
1
1
16
i
6
6 3 of the Dealer to whom6 Waybill
6 3
3. Name and address
35 issued by the CTD6: 1 35
5
5
1
1
1
1
6: 83 DECARATION
6: 83
6: 83
6: 83
Name : M/S BISMILLA
22 9
22 9
22 9
22 9
Address : 2/5/2006,ILLISIPURAM
JN,NEAR JAGANNADHA
SWAMY TEMPLE,SRIKAKULAM,ANDHRA
:1
:1
:1
:1
PRADESH,SRIKAKULAM,532001
5
5
5
5
TTIN
T
T
T
Tr
STATE : ANDHRA
PRADESH
ra : 37408731442
ra
ra
ra
an
ns
ns
ns
ns
V
V
V
V
V
4. Place
which consigned :ASRIKAKULAM
To which consigned
po
AT pFrom
AT po
AT po : VEERAGHATTAMAT spo
or
T
rte
te
37 CONSIGNOR
37 Sale
5. 1
IF THE
IS TRANSPORTING
15 37 rter THE GOODS15: After
15 37 rter
15 37 rter
5
r
r
:
:
:
:
1
1
1
1
(a) In pursuance
buyer
No 61of sale
No to6the
No 61 tir
No 61 tir
No 161 : t
tir for purpose of delivery
tir ; or
1
u
u
u
u
(b) After purchasing
v 11 them;
v 11 pa
v 11 pa
v 11 pa
v 11
p or
20 5 t
20 5 t
20 5
55 aorthgodown to an agent2for
55 th
(c) From one 2
of0the shops
sale;
0
56 hi
56 hi
1
1
1
1
16
i
i
6
6
6 3to another shop or godown 6for purpose
6 3
(d) From shop or godown
35 of storage or sale; or 6 1 35
5
5
1
1
1
1
(e) To his principal, having
them on his behalf ;6or 8
83
6: purchased
6: 83
6: 83
3
:
2
2
2
2
9
(f) To his agent for sale on2consignment
basis.
2: 9
2: 9
2: 9
:1
1
1
15
(Mark whichever is applicable)
5
5
5
Tr and address of the OtherTrDealer/Person to whom theTGoods
Tr whom Goods were Purchased
Tr :
Name
are Consigned or from
ra
an
an
a
ns or self or Agent or Principal)V ans
VA sp
VA sp
VA nsp
V(Buyer
AT po
AT po
Name
TIN : Un Registered
T3 :oNrt SURESH KUMAR T3 ort
T3 ort
r
t
1Address
15 7 er
15 7 er
15 37 er
15 37 rter
5 71 : eVEERAGHATTAM
r:
:
:
:
1
1
1
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 161 : t
u
u
u
u
6. Description,
and Value of vthe Goods
1
v 11Quantity
v 11 pa
v 11 pa
v 11
20 5 pat
20 15 pat
20 5 t
20 5 t
20 5
hi (Rs.)
56 hNo./Date
Commodity
Quantity
16 56 hi
16 56 hi
16Invoice
16 56 Value
16
i
3
35 36,307.00
16 358
16 3/515-11-2016
1
1
GYPSUM 16 58
00525
101.0000
6 8
NUMBER :2 3
:2 39
:2 39
:2 839
2:
2:
2:
2: 936,307.00
TOTAL
15
15
15
15
Tr
Tr
T
T
Tr
7. Name
an of the Owner of the goods
an vehicle or vessel by whichranthe goods are consigned : ran
a
VA sp
VA sp
VA sp
VA sp
VA nsp
or
o Transporter Name : TIRUPATHI
Tof3Transportation
T3 ort
T3No.or:t AP30W9968
T3 ort
Type
: Parcel1 T3 rte
Vehicle/Vessel
t
1
1
1
1
e
e
e
5 71 r:
5 71 r:
5 71 r:
5 71 r:
5 71 er:
Service
No 61 tir
No 61 tir
No 61 tir
No 61 tir
No 61 t
v 11 upa
v 11 upa
v 11 upa
v 11 upa
v 11
20 5: We tcertify that to the 2best
20particulars
20 5
DECLARATION
of
my/our
knowledge the
furnished here 2are
true
and
correct.
5
5
5
t
t
t
0
0
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15
Signature of the Dealer to whom Waybill issued
by the CTD
Tr
Tr
Tr
Tr
Tr
an
an
an
an
a
VA sp
VA sp
VA sp
VA sp
VA nsp
T o
T o
T o
T o
T o
15 37 rter
15 37 rter
15 37 rter
15 37 rter
15 37 rter
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : tir
No 161 : t
u
u
u
u
v 11 pa
v 11 pa
v 11 pa
v 11 pa
v 11
20 5 t
20 5 t
20 5 t
20 5 t
20 5
16 56 hi
16 56 hi
16 56 hi
16 56 hi
16
16 358
16 358
16 358
16 358
1
:2 39
:2 39
:2 39
:2 39
2:
2:
2:
2:
15
15
15
15

VAT371611155635839