DEEPSHIKHA GAS AGENCY (0000103084)

406, CIVIL LINES,

BAJORIA MARG,,
SAHARANPUR (U.P.) 247001,
SAHARANPUR, SAHARANPUR,
Uttar Pradesh-247001 India
Ph: 01327967494 GSTIN:09AARPV8890J1ZE

DELIVERY CHALLAN (ERV)

Distributor Details SAP Code 0000103084 Plant Details
SAP Plant Code 1588
Distributor Name DEEPSHIKHA GAS AGENCY SAP Plant Name LPG BP -Loni(1588)
Address 406, CIVIL LINES, SAP Plant Address 11029,
BAJORIA MARG,, SAHARANPUR (U.P.) 247001, Indane Bottling Plant, Vill. B,
SAHARANPUR, LONI -
SAHARANPUR, Uttar Pradesh,
Uttar Pradesh-247001 India
India
Distributor GSTIN 09AARPV8890J1ZE SAP Plant GSTIN 09AAACI1681G1ZN
AC4 No. SAP Document No:
AC4 Date Delivery Challan #
Truck NO. Delivery Challan Date
AC4 Plant Truck No.
AC4 Receipt
Remarks .
Date/Time at Godown

Driver Name . E-Way Bill Amount

Driver Remarks E-way Bill #

Driver Signature
AC4 Particulars
Equipment Description Quantity Sent 1-Way Good Qty 2-Way Good Qty Safety Cap

Delivery Challan Particulars

Safety Caps Tare Net Seal
S.No Equipment Code HSN Code Return Description Quantity Cylinder No. Remarks
(84818030) Weight Weight Y/N

Value :

Dispatcher's Details from Distributors Remarks by Receiving Location:

Name of Distributor /
Representative with Sign

Transporter's Remarks TallyMan's Name

Transporter's Sign TallyMan's Sign

Shift Officer's Name

Shift Officer's Sign