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ORIGINAL FOR RECEPIENT

Subject to Kanpur Jurisdiction


DUPLICATE FOR TRANSPORTER
TAX INVOICE TRIPLICATE FOR SUPPLIER
Supplier: Invoice No. : F0D1800001
RAHMAN INDUSTRIES LTD Invoice Date: 03.04.2018
184/167 Wajidpur, Jajmau,
Delivery Note No.: 8800072
Kanpur-208010 (INDIA)
Date : 03.04.2018

PO No. : SAMPLE
Ph: +91512 3931400 Email:sales@rahman-group.com
Date : 03.04.2018

GSTIN: 09AAACR6862N1ZQ STATE: UTTAR PRADESH CODE: 09


CIN:U19111UP1991PLC013871
Buyer: Delivery At:
SAFETIX PROTECTIVE EQUIPMENTS (P) Same as Buyer's Address.
LTD,PLOT NO. 19 SECTOR 90
G.B.NAGAR, ,,NOIDA-201305,Uttar
Pradesh,Contact No.
GSTIN:09AAECM2826P1ZZ,
STATE:UTTAR PRADESH,CODE:09

PLACE OF SUPPLY: STATE:UTTAR PRADESH CODE:09 Reverse Charge:No

No. of Description of Goods HSN/SAC Quantity Rate Amount Discount Taxable


GST%
PKG: CODE PRS Amount
1 carton

Weight:
5.900KG

Footwear with outer sole of 6403 4.00 799.20 3196.80 3196.80 18%
Rubber/PU/TPU

Size: 5 7 8
Pairs: 1 1 1

Size: 9
Pairs: 1

Total 4.00 3196.80 3196.80

Taxable Amount: 3196.80


TAX(IGST): 0.00
TAX(SGST): 287.72
TAX(CGST): 287.72
Rounding off: 0.24-
Grand Total: 3772
Freight Status: FREIGHT PAID
Amount Chargeable : Rupees THREE THOUSAND SEVEN HUNDRED SEVENTY TWO only.
(in words)
Transportation Mode: COURIER
Transporter Name:
Vehicle No:

HSN/SAC Taxable Central Tax State Tax


Value Rate% Amount Rate% Amount
6403 3196.80 9% 287.71 9% 287.71
Total 3196.80 287.72 287.72
Terms: FOR RAHMAN INDUSTRIES LTD

1.Goods once sold will not be taken back.


2.Our Responsibility of goods ceases after premises. Authorized Signatory
Payment within 30 days from the date of invoice.

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