General Mills India Pvt. Ltd.

WB Claim Form : Without GST on Claims

WB Code: PPUC038 WB Name: SAIF SALES
Region:WEST ASM Name: ABHISHEK SAHA
SO Name: MOHIT SAXENA JC: 5
Regional Spends MFS Central Spends
Products
Trade Promo 4333 Trade Promo 4334 REQ No if any

500gm
1KG
PCFA-6003 2KG
5KG
10KG
PMGA-6062
PPGA-6072
Rawa-6065
CCM-6047
PPC -6018
PLC-6088
Fros-6063
NV-6010
BC-6014
OCM-6001
PCCM-6005
Custard-6008
PBC

Total 0 0 0
Note: This claim is subject to verification

WB Signature & Stamp SO Signature

Date: Date:

For office use only

Credit Note No:_____________________ Date:________________
ndia Pvt. Ltd.
hout GST on Claims
ame: SAIF SALES
Name: ABHISHEK SAHA

Other
Damages - 3005 Special4340
Scheme - CLA 3004 Claims If Total
any

34702 34702
48251 48251
8836 8836

10306 10306

10295 10295

112390 0 0 112390

ASM Signature
Date:

ASM Declaration: I have verified all

supportings documents of the claim

ly
 General Mills India Pvt. Ltd.
Product Damage Report
WB Code: PPUC038 WB Name : SAIF SALES
Town: RAIPUR
Date of Disposal: 24.09.19

Sr. No. Product SKU Code Nature of Damage MRP No. of Packs Billing Amount of Credit note
Amount to WB
1 PB Cakes Choco Pastry 25 gm PCCP25G Expired 10 1705 8.43 14375
Sub Total PB Cakes Choco Pastry 25 gm 14375
2 Cookie Mini Jar 1s_5 PCCC11GJAR Expired 5 7488 4.22 31566
Sub Total Cookie Mini Jar 1s_5 31566
3 PB Cakes Redvelvet PCRP23G Expired 10 1856 8.43 15648.21
Sub Total PB Cakes Redvelvet 15648.21
4 CookerCake Choco159G_95 PCCMCHO Expired 95 39 74.14 2891.58
Sub Total CookerCake Choco159G_95 2891.58
5 Cookie Tutti 1s_10 PTFCC23g Expired 10 372 8.43 3136.39
Sub Total Cookie Tutti 1s_10 3136.39
6 AmericanBrowne4s_15CPIPL BROCKECCx4 Expired 15 814 12.647 10294.658
Sub Total AmericanBrowne4s_15CPIPL 10294.658
7 Lava Choco 1s_10CPIPL PLCC28G Expired 10 1048 8.43 8835.8
Sub Total Lava Choco 1s_10CPIPL 8835.8
8 Choco Idli 120G_95 PCCIC120G95 Expired 95 48 74.143 3558.864
Sub Total Choco Idli 120G_95 3558.864
9 Pastry StrawB 1s_10 PCSP25g Expired 10 2162 8.43 18228.14
Sub Total Pastry StrawB 1s_10 18228.14
10 Vanl Idli 120G_95 PRVIC120 Expired 10 52 74.143 3855.436
Sub Total Vanl Idli 120G_95 3855.436
Total 112390
The above Damage Stock have been inspected and disposed off by me within limits sanctioned by Office/Special Authorisation (Refer if any……………………………………………)

_________________________________________________ __________________________________________________
WB Signature & Stamp SO Signature
Date: Date: