Stock Return

Dist. Name: Xyz

Location: DELHI

Region: NORTH

Month: Dec-18

Distributor's Billing
Primary
Price(Without
SAP Code Desc MRP Scheme) Sch

w345566 Tulsi Green 25 Tea Bags 174 128.05 7.14

TOTAL

ASM/RSM
Distributor Sign & Stamp Sign & Name
Date of Sign Date of Sign

NOTE:

(1) Invoice Ref No. is mandatory

Return

Distributor's
Billing
Price(After Total Amount (To
Scheme) Batch Invoice No. Invoice Date Invoice Qty. Be Claim)

118.91 DLC1098766 31.01.2019 10 1,189.09

1,189.09
GST +
G. Total 1,189.09

NSM Commercial Mgr.

Sign & Name Sign & Name
Date of Sign Date of Sign

CSMO
Sign & Name
Date of Sign
 Distributor's Claims Summary
Dist. Code

Dist. Name: UNITED AGENCIS

Location: KERALA

Region: SOUTH

Month: Aug-19

SL No. Descriptions Amount

1 Margin Difference 15856.40
2 Display /Visibilty claims 120360.00
3 Display BANDHAN
4 Sample Claims
5 Price Difference (in primary Invoice) Claims 10301.40
6 Expiry Claims
7 Damage Claims
8 Others- Branding Expenses 19658.80
Total 166176.60

Sales Executive ASM/RSM NSM/DGM/GM Commercial Mgr. Commercial Head/CFO

Distributor Sign & Stamp Sign & Name Sign & Name Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign

NOTE:
Supporting Documents Required along with this claims
(1) All the suorting docs. Are mandatory CSMO
(1) Without Supporting Doc. Claims will not be enternain. Sign & Name
Date of Sign
 Margin Difference Claim Format

Dist. Name: Backiam businees corporation Customer Name ELITE

Location: Kerala Customer Margin 25%

Region: South

Month: February

Distributor's Billing Rate

Distributor's Billing Price(Without Price(After Customer Billing Retailers Difference(Per
SAP Code Desc MRP Scheme) Primary Scheme) Price Landed Price Pcs) Sales Qty. Total Amount (To Be Claim)
1400479 DOM Stevia 25 Sachet Box 95 62.21 7.14 57.77 60.38 63.99 3.61 -
1400000 DOM Tulsi Ginger 100g Tin 190.00 131.09 7.14 121.73 127.23 134.84 7.60 - 12
1400001 DOM Tulsi Ginger 100g Zipper 140.00 96.59 7.14 89.69 93.75 99.35 5.60 -
1400002 DOM Tulsi Ginger 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 - 99.107143 12
1400003 DOM Tulsi Ginger 50g Box 85.00 58.64 7.14 54.46 56.92 60.32 3.40 -
1400004 DOM Tulsi Original 100g Tin 190.00 131.09 7.14 121.73 127.23 134.84 7.60 -

1400005 DOM Tulsi Original 100g Zipper 140.00 96.59 7.14 89.69 93.75 99.35 5.60 -
1400006 DOM Tulsi Original 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 -
1400007 DOM Tulsi Original 50g Box 85.00 58.64 7.14 54.46 56.92 60.32 3.40 -
1400047 DOM Tulsi Brahmi 25 IB 154.00 106.25 7.14 98.66 103.13 109.29 6.16 -
1400048 DOM Tulsi Cleanse 25 IB 154.00 106.25 7.14 98.66 103.13 109.29 6.16 -
1400049 DOM Tulsi Ginger Turmeric 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 -
1400051 DOM Tulsi Honey Chamomile 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 -
1400052 DOM Tulsi CINNAMON GILOY 25Tb 184.00 126.95 7.14 117.88 123.21 130.58 7.36 -
1400053 DOM Tulsi Mulethi 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 -
1400054 DOM Tulsi Sleep 25 IB 154.00 106.25 7.14 98.66 103.13 109.29 6.16 -
1400055 DOM Tulsi Sweet Rose 25 IB 148.00 102.11 7.14 94.82 99.11 105.03 5.92 -
1400065 DOM Tulsi Tummy 25 IB 154.00 106.25 7.14 98.66 103.13 109.29 6.16 -
1400008 DOM Tulsi Green Tea Classic 100g T 230.00 169.26 7.14 157.18 164.29 174.11 9.82 -
1400009 DOM Tulsi Green Tea Classic 25 IB 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1400010 DOM Tulsi Green Tea Classic 100g Z 175.00 128.79 7.14 119.59 125.00 132.47 7.47 3 22.41
1400011 DOM Tulsi Green Tea Classic 50g Box 105.00 77.27 7.14 71.76 75.00 79.48 4.48 -

1400023 TULSI GT ASSORTED PACK 25Tb 184.00 135.41 7.14 125.74 131.43 139.28 7.86 -
1400050 DOM Tulsi Green Tea Lemon Ginger 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1400056 DOM Tulsi Green Tea Classic 10 IB 74.00 54.46 7.14 50.57 52.86 56.02 3.16 -
1400057 DOM Tulsi Green Tea Earl Grey 25 I 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1400058 DOM Tulsi Green Tea Jasmine 25 IB 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1400059 DOM Tulsi Green Tea Pomegranate 2 174.00 128.05 7.14 118.91 124.29 131.71 7.43 3 22.29
1400060 DOM Tulsi Masala Chai 100g Tin 230.00 169.26 7.14 157.18 164.29 174.11 9.82 -
1400061 Tulsi Masala Chai Zipper 100Gm 175.00 128.79 7.14 119.59 125.00 132.47 7.47 -
1400062 DOM Tulsi Masala Chai 25 IB 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1400063 AYUSH KWATH 25TB 184.00 135.41 7.14 125.74 131.43 139.28 7.86 -
1400064 DOM Tulsi Sweet Lemon 25 IB 154.00 113.33 7.14 105.24 110.00 116.57 6.57 -
1400262 DOM Executive Kappa Gift 60 IB Box 499.00 367.23 7.14 341.01 356.43 377.73 21.30 -
1400368 DOM Darjeeling Tea 100g Tin 250.00 183.98 7.14 170.85 178.57 189.24 10.67 -
1400369 DOM Darjeeling Tea 18 IB 175.00 128.79 7.14 119.59 125.00 132.47 7.47 -
1401134 DOM Tulsi Green Tea Ashwagandha 174.00 128.05 7.14 118.91 124.29 131.71 7.43 -
1401166 DOM Tulsi Green Tea Assorted Pack 184.00 135.41 7.14 125.74 131.43 139.28 7.86 -
1401195 DOM PINK ROCK SALT 100g 110 80.00 7.14 74.29 82.50 82.29 -0.21 -
1401201 DOM Pink Rock Salt 1kg Pack 140 101.82 0 101.82 105.00 112.00 7.00 -
1400020 Amala Yummies 95.00 65.80 7.14 61.10 67.86 67.68 -0.17 -
1400021 DOM Psyllium Whole Husk 100g Can 195.00 135.06 7.14 125.42 139.29 138.93 -0.36 -
1400022 DOM Quinoa 500g 295.00 204.33 0 204.33 210.71 224.76 14.05 6 84.29
1400025 DOM Coconut Oil Virgin 500ml 725.00 502.16 0 502.16 517.86 552.38 34.52 -
1400478 DOM Honey (Wild Forest)250g 195.00 135.06 7.14 125.42 139.29 138.93 -0.36 4 (1.43)
1400480 Ashwagandha Lehya 250 Gm 285.00 197.40 7.14 183.31 203.57 203.05 -0.52 -
1400559 DOM Chyawanprash 500gm 495.00 342.86 0 342.86 353.57 377.14 23.57 -
1400016 DOM Bowelcare 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1400026 DOM Ghee 500ml 595.00 386.36 0 386.36 398.44 425.00 26.56 -
1400094 DOM Amalaki 60 Cap 175.00 113.64 7.14 105.52 117.19 116.89 -0.30 -

1400095 DOM Ashwagandha 60 Cap 205.00 133.12 7.14 123.61 137.28 136.92 -0.35 3 (1.06)
1400096 DOM Beautiful Skin 60 Cap 225.00 146.10 5 138.80 150.67 153.41 2.74 -
1400097 DOM Brahmi 60 Cap 205.00 133.12 10 119.81 137.28 133.12 -4.16 -
1400098 DOM Breathe Free 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1400099 DOM Cinnamon 60 Cap 175.00 113.64 0 113.64 117.19 125.00 7.81 -
1400100 DOM Flaxseed Oil 60 Cap 495.00 321.43 7.14 298.48 331.47 330.62 -0.85 -
1400101 DOM Flexibility 60 Cap 225.00 146.10 0 146.10 150.67 160.71 10.04 -
1400102 DOM Heart Guard 60 Cap 225.00 146.10 5 138.80 150.67 153.41 2.74 -
1400103 DOM Immunity 60 Cap 225.00 146.10 0 146.10 150.67 160.71 10.04 -
1400104 DOM Lipid Care 60 Cap 225.00 146.10 0 146.10 150.67 160.71 10.04 -
1400106 DOM Moringa 60 Cap 175.00 113.64 7.14 105.52 117.19 116.89 -0.30 -
1400107 DOM Neem 60 Cap 174.00 112.99 7.14 104.92 116.52 123.99 7.47 -
1400108 DOM Oh Boy 30 Cap 499.00 324.03 7.14 300.89 334.15 333.29 -0.86 -
1400109 DOM Osteoseal 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1400110 DOM Prostate Care 60 Cap 225.00 146.10 5 138.80 150.67 153.41 2.74 -
1400111 DOM Shatavari 60 Cap 175.00 113.64 10 102.27 117.19 113.64 -3.55 -
1400112 DOM Sugr Balance 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1400113 DOM Trikatu 60 Cap 175.00 113.64 0 113.64 117.19 125.00 7.81 -
1400114 DOM Tulsi 60 Cap 175.00 113.64 10 102.27 117.19 113.64 -3.55 -
1400115 DOM Turmeric Formula 60 Cap 295.00 191.56 10 172.40 197.54 191.56 -5.99 -
1400116 DOM Vitality 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1400117 DOM Wt Balance 60 Cap 225.00 146.10 0 146.10 150.67 160.71 10.04 -
1400861 DOM Peaceful Sleep 60 Cap 225.00 146.10 5 138.80 150.67 153.41 2.74 -
1401186 DOM Women's Well Being 60 Cap 210.00 136.36 0 136.36 140.63 150.00 9.37 -
1401515 Neem 10 cap strip 40.00 25.97 10 23.38 26.79 25.97 -0.81 -
1401582 DOM Liver Kidney Care 60 Cap 225.00 146.10 0 146.10 150.67 160.71 10.04 -
1400534 DOM Apple Cider Vinegar 500ml 595 366.72 0 366.72 378.18 403.39 25.21 -
1400535 JAGERRY POWDER500g 85 52.39 0 52.39 54.03 57.63 3.60 -
1400067 DOM Tulsi Green Tea Lemon Ginger 338 222.11 222.11 241.43 222.11 -19.31 -
126.49
NOTE:
Supporting Documents Required along with this claims
(1) Customer Acknowledged Copy of Invoice CSMO
(2) Purchases Order Sign & Name
(3) Sales Summary Date of Sign
 Display /Visibilty Claims

Dist. Name: RAJESH TRADERS

Location: KERALA

Region: SOUTH

Month: August

Customer
GST Period Total Amount
Dibit Note Total Amount (To
Sl No. Customer Name Location Value Value Taxable Value From To Month Per Month Be Claim)
1 Greens Super Mrket Kerala 3000.00 0 0.00 Jun-19 Aug-19 3 1000 3,000.00
2 Fathima Hyper Kerala 22500.00 0 0.00 Apr-19 Jun-19 3 7500 22,500.00
3 Elite Super Market Kerala
4 EMKAY Kerala
5 KALYAN

TOTAL 25,500.00

Sales Executive ASM/RSM NSM Commercial Mgr. Commercial Head/CFO

Distributor Sign & Stamp Sign & Name Sign & Name Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign

NOTE:
Supporting Documents Required along with this claims
(1) Customer Acknowledged Copy of Receipts CSMO
(2) Customer Debit note Copy Sign & Name
(3) Sales Summary of particular month Date of Sign
 Display /Visibilty Claims

Dist. Name: Xyz

Location: DELHI

Region: NORTH

Month: Dec-18

GST
Customer Dibit Taxable
Sl No. Customer Name Location Note Value Value Value
1 Rama Store 100.00 18 82.00

TOTAL

Sales Executive ASM/RSM NSM

Distributor Sign & Stamp Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign

NOTE:
Supporting Documents Required along with this claims
(1) Customer Acknowledged Copy of Receipts
(2) Customer Debit note Copy
(3) Sales Summary of particular month
lty Claims

Period Total Amount

Total Amount (To
From To Month Per Month Be Claim)
Jan-19 Jan-19 1 100 82.00

82.00

Commercial Mgr. Commercial Head/CFO

Sign & Name Sign & Name Sign & Name
ate of Sign Date of Sign Date of Sign

CSMO
Sign & Name
Date of Sign
 Sample claims

Dist. NamXyz

Location: DELHI

Region: NORTH

Month: Dec-18

Distributor's Distributor's
Billing Billing
Primary
Price(Witho Price(After
SAP Code Desc MRP ut Scheme) Sch Scheme) Batch MFD
w345566 Tulsi Green 174 128.05 7.14 118.91
105 68.18 7.14 63.31

TOTAL
 Sales Executive ASM/RSM NSM Commercial Mgr.
Distributor Sign & S Sign & Name Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign

NOTE:
Supporting Documents Required along with this claims
(1) Prior Approval to Issue Sample of RSM/NSM CSMO
Sign & Name
Date of Sign
 Sample Qty.
Total Amount (To
Purpose Qty. Be Claim)
10 1,189.09
10 633.14

1,822.23
Commercial Mgr. Commercial Head/CFO
Sign & Name Sign & Name
Date of Sign Date of Sign

CSMO
Sign & Name
Date of Sign
 Price Difference claims (Primary Inv

Dist. Name: 2110543

Location: Kerala

Region: South 1

Month: Aug-19

Distributor's
Distributor's Billing Billing
Primary
Price(Without Price(After
SAP Code Desc MRP Scheme) Sch Scheme)
1400121 Pink Rock Salt 1KG 120 87.26 0 87.26

TOTAL

Sales ExecutASM/RSM NSM

Distributor Sign & Stamp Sign & Nam Sign & Name Sign & Name
Date of Sign Date of SignDate of Sign Date of Sign
NOTE:
Supporting Documents Required along with this claims
(1) Invoice Copy
ms (Primary Invoice)

Total Amount (To

Invoice Rate Invoice No. Invoice Date Invoice Qty. Be Claim)
101.81 9036000287 29.6.19 600 8,730.00
-

8,730.00

Commercial Mgr. Commercial Head/CFO

Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign
 CSMO
Sign & Name
Date of Sign
 Expiry Claims

Dist. NamXyz

Location: DELHI

Region: NORTH

Month: Jan-19

Distributor's Distributor's
Billing Billing
Primary
Price(Witho Price(After
SAP Code Desc MRP ut Scheme) Sch Scheme) Batch No. MFD
w345566 Tulsi Green 174 128.05 7.14 118.91

TOTAL

Sales Executive ASM/RSM NSM Commercial Mgr.

Distributor Sign & S Sign & Name Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign
NOTE:
Supporting Documents Required along with this claims
(1) Prior Approval from NSM for destruction of Expired & Damaged stocks CSMO
(2) This will be based on Complete material list prepared & sent by C & F if Sign & Nam
(3) This will be destroyed post approval Date of Sign
(4) Claim will be prepared and sent to Delhi office for approval alongwith Distributor letter head, m
(5) The material destroyed sheet will be signed by C &F , RSM/Manager and TSO and to be attach
(6) The GST invoice for claim to be enclosed alongwith .
 Damage/exp. Qty
Total Amount (To
Reason Qty. Be Claim)
10 1,189.09
-

1,189.09

Commercial Mgr. Commercial Head/CFO

Sign & Name Sign & Name
Date of Sign Date of Sign
 CSMO
Sign & Name
Date of Sign
Distributor letter head, material list and snaps of material destroyed
nd TSO and to be attached with claim sent
 Expiry Claims

Dist. NamXyz

Location: DELHI

Region: NORTH

Month: Jan-19

Distributor's Distributor's
Billing Billing
Primary
Price(Witho Price(After
SAP Code Desc MRP ut Scheme) Sch Scheme) Batch No. MFD
w345566 Tulsi Green 174 128.05 7.14 118.91

TOTAL

Sales Executive ASM/RSM NSM Commercial Mgr.

Distributor Sign & S Sign & Name Sign & Name Sign & Name Sign & Name
Date of Sign Date of Sign Date of Sign Date of Sign Date of Sign
NOTE:
Supporting Documents Required along with this claims
(1) Prior Approval from NSM for destruction of Expired & Damaged stocks CSMO
(2) This will be based on Complete material list prepared & sent by C & F if Sign & Nam
(3) This will be destroyed post approval Date of Sign
(4) Claim will be prepared and sent to Delhi office for approval alongwith Distributor letter head, m
(5) The material destroyed sheet will be signed by C &F , RSM/Manager and TSO and to be attach
(6) The GST invoice for claim to be enclosed alongwith .
 Damage/exp. Qty
Total Amount (To
Reason Qty. Be Claim)
10 1,189.09
-

1,189.09

Commercial Mgr. Commercial Head/CFO

Sign & Name Sign & Name
Date of Sign Date of Sign
 CSMO
Sign & Name
Date of Sign
Distributor letter head, material list and snaps of material destroyed
nd TSO and to be attached with claim sent