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Tax Invoice (ORIGINAL FOR RECIPIENT)

OM INFOTECH Invoice No. Dated


C-2,F NO. 401, SHUBHSHREE RESIDENCE OM/23-24/32 9-Nov-23
JAI GANESH VISION, AKURDI PUNE Delivery Note Mode/Terms of Payment
GSTIN/UIN: 27AJSPG8712G1ZX
State Name : Maharashtra, Code : 27 Buyer’s Order No. Dated
E-Mail : om_infotech15@yahoo.com 8000083771 14-Oct-23
Dispatch Doc No. Delivery Note Date
Consignee (Ship to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199) Dispatched through Destination
D39, MIDC AREA, WALUJ AURANGABAD
431136 Terms of Delivery
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27
Buyer (Bill to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199)
D39, MIDC AREA, WALUJ AURANGABAD
431136
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27

Sl Description of Goods HSN/SAC GST Quantity Rate per Disc. % Amount


No. Rate

1 5100067549/hard Disk 4 8523 18 % 1 pcs 10,250.00 pcs 10,250.00


Tb/8523
2 Laptop Charger Hsn 8504 18 % 1 NOS 1,150.00 NOS 1,150.00
8504
11,400.00
Output CGST @9% 9% 1,026.00
Output SGST @9% 9% 1,026.00

Total 13,452.00
Amount Chargeable (in words) E. & O.E
INR Thirteen Thousand Four Hundred Fifty Two Only
Taxable Central Tax State Tax Total
Value Rate Amount Rate Amount Tax Amount
11,400.00 9% 1,026.00 9% 1,026.00 2,052.00
Total: 11,400.00 1,026.00 1,026.00 2,052.00

Tax Amount (in words) : INR Two Thousand Fifty Two Only
Declaration
We declare that this invoice shows the actual price of the goods described and that all particulars are true
and correct.

Customer’s Seal and Signature for OM INFOTECH

Authorised Signatory
SUBJECT TO PUNE JURISDICTION
This is a Computer Generated Invoice
Tax Invoice (DUPLICATE FOR TRANSPORTER)

OM INFOTECH Invoice No. Dated


C-2,F NO. 401, SHUBHSHREE RESIDENCE OM/23-24/32 9-Nov-23
JAI GANESH VISION, AKURDI PUNE Delivery Note Mode/Terms of Payment
GSTIN/UIN: 27AJSPG8712G1ZX
State Name : Maharashtra, Code : 27 Buyer’s Order No. Dated
E-Mail : om_infotech15@yahoo.com 8000083771 14-Oct-23
Dispatch Doc No. Delivery Note Date
Consignee (Ship to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199) Dispatched through Destination
D39, MIDC AREA, WALUJ AURANGABAD
431136 Terms of Delivery
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27
Buyer (Bill to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199)
D39, MIDC AREA, WALUJ AURANGABAD
431136
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27

Sl Description of Goods HSN/SAC GST Quantity Rate per Disc. % Amount


No. Rate

1 5100067549/hard Disk 4 8523 18 % 1 pcs 10,250.00 pcs 10,250.00


Tb/8523
2 Laptop Charger Hsn 8504 18 % 1 NOS 1,150.00 NOS 1,150.00
8504
11,400.00
Output CGST @9% 9% 1,026.00
Output SGST @9% 9% 1,026.00

Total 13,452.00
Amount Chargeable (in words) E. & O.E
INR Thirteen Thousand Four Hundred Fifty Two Only
Taxable Central Tax State Tax Total
Value Rate Amount Rate Amount Tax Amount
11,400.00 9% 1,026.00 9% 1,026.00 2,052.00
Total: 11,400.00 1,026.00 1,026.00 2,052.00

Tax Amount (in words) : INR Two Thousand Fifty Two Only
Declaration
We declare that this invoice shows the actual price of the goods described and that all particulars are true
and correct.

Customer’s Seal and Signature for OM INFOTECH

Authorised Signatory
SUBJECT TO PUNE JURISDICTION
This is a Computer Generated Invoice
Tax Invoice (TRIPLICATE FOR SUPPLIER)

OM INFOTECH Invoice No. Dated


C-2,F NO. 401, SHUBHSHREE RESIDENCE OM/23-24/32 9-Nov-23
JAI GANESH VISION, AKURDI PUNE Delivery Note Mode/Terms of Payment
GSTIN/UIN: 27AJSPG8712G1ZX
State Name : Maharashtra, Code : 27 Buyer’s Order No. Dated
E-Mail : om_infotech15@yahoo.com 8000083771 14-Oct-23
Dispatch Doc No. Delivery Note Date
Consignee (Ship to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199) Dispatched through Destination
D39, MIDC AREA, WALUJ AURANGABAD
431136 Terms of Delivery
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27
Buyer (Bill to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199)
D39, MIDC AREA, WALUJ AURANGABAD
431136
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27

Sl Description of Goods HSN/SAC GST Quantity Rate per Disc. % Amount


No. Rate

1 5100067549/hard Disk 4 8523 18 % 1 pcs 10,250.00 pcs 10,250.00


Tb/8523
2 Laptop Charger Hsn 8504 18 % 1 NOS 1,150.00 NOS 1,150.00
8504
11,400.00
Output CGST @9% 9% 1,026.00
Output SGST @9% 9% 1,026.00

Total 13,452.00
Amount Chargeable (in words) E. & O.E
INR Thirteen Thousand Four Hundred Fifty Two Only
Taxable Central Tax State Tax Total
Value Rate Amount Rate Amount Tax Amount
11,400.00 9% 1,026.00 9% 1,026.00 2,052.00
Total: 11,400.00 1,026.00 1,026.00 2,052.00

Tax Amount (in words) : INR Two Thousand Fifty Two Only
Declaration
We declare that this invoice shows the actual price of the goods described and that all particulars are true
and correct.

Customer’s Seal and Signature for OM INFOTECH

Authorised Signatory
SUBJECT TO PUNE JURISDICTION
This is a Computer Generated Invoice
Tax Invoice (EXTRA COPY)

OM INFOTECH Invoice No. Dated


C-2,F NO. 401, SHUBHSHREE RESIDENCE OM/23-24/32 9-Nov-23
JAI GANESH VISION, AKURDI PUNE Delivery Note Mode/Terms of Payment
GSTIN/UIN: 27AJSPG8712G1ZX
State Name : Maharashtra, Code : 27 Buyer’s Order No. Dated
E-Mail : om_infotech15@yahoo.com 8000083771 14-Oct-23
Dispatch Doc No. Delivery Note Date
Consignee (Ship to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199) Dispatched through Destination
D39, MIDC AREA, WALUJ AURANGABAD
431136 Terms of Delivery
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27
Buyer (Bill to)
BELRISE INDUSTRIES LTD.UNIT-9B (1199)
D39, MIDC AREA, WALUJ AURANGABAD
431136
GSTIN/UIN : 27AAACB9378F2ZF
State Name : Maharashtra, Code : 27

Sl Description of Goods HSN/SAC GST Quantity Rate per Disc. % Amount


No. Rate

1 5100067549/hard Disk 4 8523 18 % 1 pcs 10,250.00 pcs 10,250.00


Tb/8523
2 Laptop Charger Hsn 8504 18 % 1 NOS 1,150.00 NOS 1,150.00
8504
11,400.00
Output CGST @9% 9% 1,026.00
Output SGST @9% 9% 1,026.00

Total 13,452.00
Amount Chargeable (in words) E. & O.E
INR Thirteen Thousand Four Hundred Fifty Two Only
Taxable Central Tax State Tax Total
Value Rate Amount Rate Amount Tax Amount
11,400.00 9% 1,026.00 9% 1,026.00 2,052.00
Total: 11,400.00 1,026.00 1,026.00 2,052.00

Tax Amount (in words) : INR Two Thousand Fifty Two Only
Declaration
We declare that this invoice shows the actual price of the goods described and that all particulars are true
and correct.

Customer’s Seal and Signature for OM INFOTECH

Authorised Signatory
SUBJECT TO PUNE JURISDICTION
This is a Computer Generated Invoice

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