Tax Invoice/Bill of Supply/Cash Memo

(Original for Recipient)

Sold By : Billing Address :

COCOBLU RETAIL LIMITED Ankit Giri
* Kh No 18//21, 19//25, 34//5, 6, 7/1 min, 14/2/2 1105, Tower 7, GH7, Crossing Republic
min, 15/1 min, 27, 35//1, 7, 8, 9/1, 9/2, 10/1, 10/2, GHAZIABAD, UTTAR PRADESH, 201016
11 min, 12, 13, 14, Village - Jamalpur IN
Gurgaon, Haryana, 122503 State/UT Code: 09
IN

Shipping Address :
PAN No: AAJCC8517E Ankit Giri
GST Registration No: 06AAJCC8517E1ZP Ankit Giri
1105, Tower 7, GH7, Crossing Republic
GHAZIABAD, UTTAR PRADESH, 201016
IN
State/UT Code: 09
Place of supply: UTTAR PRADESH
Place of delivery: UTTAR PRADESH
Order Number: 408-0034651-8290721 Invoice Number : DEL4-3666840
Order Date: 25.02.2023 Invoice Details : HR-DEL4-1271137075-2223
Invoice Date : 25.02.2023

This is a replacement issued free of cost against the original order(s) and invoice(s) listed in
detail below.
Sl. Net Tax Tax Tax Total
Description Unit Price Qty
No Amount Rate Type Amount Amount
1 Pepe Jeans Women's Slim Jeans (PILC0003489_Ant-Blue_30) |
B0754K6X9L ( B0754K6X9L ) ₹0.00 1 ₹0.00 5% IGST ₹0.00 ₹0.00
HSN:62046110
Original
Original Order / Original Invoice Price
407-6833473-4139568 / DEL4-3659303
₹2,499.00
TOTAL: ₹0.00 ₹0.00
Amount in Words:
Zero only
For COCOBLU RETAIL LIMITED:

Authorized Signatory
Whether tax is payable under reverse charge - No

*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)

Customers desirous of availing input GST credit are requested to create a Business account and purchase on Amazon.in/business from Business eligible offers

Please note that this invoice is not a demand for payment

Page 1 of 1