(Amended)

Government of India
Form GST REG-06
[See Rule 10(1)]

Registration Certificate

Registration Number :21AAFAS4209K2ZM

1. Legal Name SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

2. Trade Name, if any SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

3. Constitution of Business Society/ Club/ Trust/ AOP

4. Address of Principal Place of NUA SASAN, PIPILI, NUA SASAN, Puri, Odisha, 752104
Business

5. Date of Liability

6. Date of Validity From 07/03/2018 To Not Applicable

7. Type of Registration Regular

8. Particulars of Approving Authority Centre Goods and Services Tax Act, 2017

Signature

Name Naveen Kumar

Designation Superintendent

Jurisdictional Office Puri Circle

9. Date of issue of Certificate 16/02/2021

Note: The registration certificate is required to be prominently displayed at all places of Business/Office(s) in the State.

This is a system generated digitally signed Registration Certificate issued based on the approval of application granted on 16/02/2021 by
the jurisdictional authority.
 Annexure A

Details of Additional Place of Business(s)

GSTIN 21AAFAS4209K2ZM

Legal Name SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

Trade Name, if any SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

Total Number of Additional Places of Business(s) in the State 0

 Annexure B

GSTIN 21AAFAS4209K2ZM

Legal Name SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

Trade Name, if any SRI SRI LAXMINRUSINGHA DEV PANI PANCHAYAT

Details of Members of Managing Committee

1 Name DUSHASAN NANDA

Designation/Status PRESIDENT

Resident of State Odisha

2 Name HEMANT KUMAR NANDA

Designation/Status PRESIDENT

Resident of State Odisha