GAINWELL COMMOSALES PRIVATE LIMITED

VENDOR DECLARATION FORM

1. GCPL internal vendor code : …………………………………………………

BANSAL BROTHERS
2. Name :
…………………………………………………
SILIGURI , WEST BENGAL
3. Address of Vendor:
…………………………………………………
……………………………………………………………………………………………………………...
PAN (please provide a copy) :
ADQPB4075M
4. (‘Not Applicable if vendor does not
…………………………………………………
holds PAN)

GSTN :
19ADQPB4075M1Z1
5. (‘Not Applicable if vendor does not
…………………………………………………..
holds GSTN)

SANJAY BANSAL
6. Name of Contact Person
………………………………………...
7. E-Mail of Contact Person: Sanjaybansal98323@gmail.com …………………..

8. Mobile No. of the Contact Person: 8637828418…………………………..

9. Please provide below-mentioned details of your Income Tax Returns (ITR)

Financial Assessment
Acknowledgement No. of ITR Date of fling of ITR
Year Year
2019-20 2020-21 NEW
2020-21 2021-22 NEW
2021-22 2022-23 **NEW **
Please provide copy of the acknowledgement of ITR filed
**Same will be filed within relevant due dates

10. Please provide details of your aggregate TDS/TCS deducted

Financial Assessment Aggregate TDS/TCS deducted exceeds

Year Year Rs. 50,000
2019-20 2020-21 Yes No

Yes No
2020-21 2021-22
Yes No
2021-22 2022-23

I……………………………..(Name) son/daughter of………………………………in the capacity

of ……………………………(designation), on behalf of ……………………………….(name of the
entity), verify to the best of my knowledge and belief, information given in this form is
correct and complete and that the other particulars shown therein are truly stated.

Place:-KOLKATA Subhendu Bikas Pal

Date:-2/9/2022 (Signature)
(Designation)