Subscriber : Miss Ankita Ashok Gole Invoice No.

: KA02053168

Date: 04/08/2022 09:13

Customer ID: C2104085093 Place of Supply: Karnataka
Address: 507,Floor-5,NA-Block-F,Platinum
Address: C/o SMARTWORKS COWORKING
City,Yeshwanthpura,Yeswanthpura Industrial Area SPACES PRIVATE LIMITED,Tata Play
Broadband Private Limited,, Sargod

State with PIN: Karnataka-560022

State Code: 29
Landline Number :
PAN No : TPBB GSTIN: 29AAACQ3943P1ZT

GSTIN :

HSN / Description of Goods / Description

Sr. No. Base Amount Discount Amount Total Amount
SAC of services

1 998422 Internet Access Services INR 2,565.25 INR 0.00 INR 3,027.00

SUMMARY OF CHARGES AMOUNT

Base Amount : INR 2,565.25

Tax Amount : INR 461.75
CGST @9% : INR 230.87
SGST/UTGST @9% : INR 230.87
IGST @0% : INR 0.00
Amount in words : Rupees Three Thousand Twenty Seven and Zero Paise
only.

Signature Not Verified

Digitally signed by DS TATA
PLAY BROADBAND
PRIVATE LIMITED 01
Date: 2022.09.12 10:50:03 IST
Jaihind Singh
Subscriber Name: Miss Ankita Ashok Gole Annexure Number: CPH002464708

Date: 08/08/2022
Customer ID: C2104085093 Place of Supply: Karnataka
Address: 507,Floor-5,NA-Block-F,Platinum
City,Yeshwanthpura,Yeswanthpur Address: C/o SMARTWORKS
a Industrial Area COWORKING SPACES
PRIVATE
State with PIN: Karnataka- 560022
Landline Number:
PAN No : State Code: 29

GSTIN : TPBB GSTIN: 29AAACQ3943P1ZT

Please find below indicative details of appropriation of amount paid by you towards 150 Mbps Unlimited Data Plan

Period From Period To Days Amount with GST

07/08/2022 05/09/2022 30 1062.00
06/09/2022 05/10/2022 30 1062.00
06/10/2022 04/11/2022 30 1062.00

Please note that Tax Invoice is issued for receipt of amount of recharge done. Annexure contains the details of plan
subscribe for specified period and the payment made by way of current recharge amount or balance of credit
available in your wallet or both. The above appropriation is indicative breakup for your understanding only and has
no legal binding on Tata Play Broadband Private Limited (Formerly known as Tata Sky Broadband Private Limited ).

Please also note that this Annexure is subject to all the terms and conditions mentioned in the CAF duly signed by you.

This is computer generated annexure and therefore does not require any signature.