Reliance Retail Limited

C-51 Yard, Plot No.9, Road No.8, APIIC IDA Park,

Thammavaram, Village, Vakalpudi, Kakinada, Dist-East
Godavari, Kakinada, Andhra Pradesh, 533005

(Original for Recipient)

Tax Invoice

Invoice No : 28R23I0011400636 Invoice/Payment Date & Time : 04 Jul,2022 10:23:57

PAN No : AABCR1718E GST No : 37AABCR1718E1ZO

Order Ref. No. : BR0007XSV0VT Payment Ref. No. : 10112218537416982000

Mode of Payment : Debit Card

Customer Name : Shakamuri Bala Tripura Sundari Place of Supply : 37 Andhra Pradesh

Jio Number : 9849229273 Address : 30-5-1/2, Buckinghampet, durga agraharam sri

lakshmi apartments t 4, durga agraharam sri
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Sr. Taxable Amount( `)

Plan Details SAC Qty MRP/Unit( `) Discount( `)
No.

1 Rs 719-3m-2GB/D 998413 1 719.00 0.00 609.32

Total Taxable Amount 609.32

CGST (9%) 54.84

SGST (9%) 54.84

Total Amount 719.00

Total Amount (in words) Seven Hundred Nineteen Rupees Only

Telecommunication services to be provided by Reliance Jio Infocomm Limited

All disputes are subjected to Mumbai Jurisdiction
Tax is not payable under Reverse Charge basis for this supply.

Declaration : Certified that all the particulars given above are true and correct

Digitally signed by DS RELIANCE RETAIL LIMITED

Date: 2022.07.20 14:57:43 IST
Reason: Invoice
Location: 37 Andhra Pradesh

Authorized Signatory

Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
CIN: U01100MH1999PLC120563 www.relianceretail.com