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TAX INVOICE

(Mandatory on the letter head)

Details of Service Supplier Details of Service Recipient


Name & Address of Service Provider Name & Address of Service Recipient
Jai Hari Automobiles Bajaj Allianz General Insurance Company Ltd
MAHMADA HARPUE,PUSHA 6th floor,Alankar palace,Boaring Road crossing
SAMASTIPUR Bihar-848101 ,PATNA-800001
Goods & Service Tax no (GSTN) Goods & Service Tax no (GSTN)
10ALZPB7080M2ZP 10AABCB5730G1ZC
PAN ALZPB7080M PAN AABCB5730G
State State code State State Code
Bihar 10 BIHAR 10
Invoice no. JHA/JAN/2023
Date 2/6/2023
CIN NA
SAC 997161
Classification of Insurance Brokerage And Agency
Service Services
Sr No Description of Service Value

1 Distribution Fees payable for the period Month-JAN-2023-SF 2300

Taxable Value 2300


Details of Goods & Service tax payable
CGST 9.0% 207
SGST / UTGST 9.0% 207
Total Amount Payable 2714
Whether Tax is payable on reverse charge on this invoice NO
Total in Words TWO THOUSAND SEVEN HUNDRED FOURTEEN ONLY .

For-JAI HARI AUTOMOBILES - 40001041

Authorised Signatory

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