Delivery Challan

[See Rule 10 under Tax Invoice, Credit and Debit Note Rules] DC Number : OR/23-24/DC/0838
DC Date : 17-Feb-24
Ref No : 91717318147 `
Ref Date : 15-Feb-24
ORIGINAL FOR RECIPIENT DUPLICATE FOR TRANSPORTER TRIPLICATE FOR SUPPLIER
Consignor Detail (or Sender or Source location): Consignee Detail (or Receiver or Destination location):
ATC Telecom Infrastructure Pvt. Ltd. ATC Telecom Infrastructure Pvt. Ltd.
BILASINI MOHAPATRA AT/PO/PS-ANANDAPUR DIST-KEONJHAR #94371319206, 9437139206 KUNJA BIHARI NANDA,S/O-DAYANIDHI NANDA,AT-CHAMPUA

City: Keonjhar PIN Code: City: Keonjhar PIN Code:

State: ODISHA GST State Code: 21 State: ODISHA GST State Code: 21
Global Site ID 508558 Site Name: ANANDAPUR Global Site ID 453539 Site Name: CHAMPUA
GSTIN: 21AACCT1282E1ZV India Site ID OR3167 GSTIN: 21AACCT1282E1ZV India Site ID OR_CMPA001
Transport Details
E- Waybill No. : Movement Type
Transporter Name : Warehouse to Site (MRN) : :
Vehicle No. : Site Return Note (SRN) : :
LR No. : Asset Transfer Note (ATN) : : ATN
LR Date : Returnable gate-pass (RGP) : :
Vehicle Type : Any other (Please specify) : :
Place of Supply : ODISHA , 21
Item Code - Item Description - Sub-Inventory 3 SGST /UTGST IGST CESS
Sr. # Taxable Value
HSN Code Qty UOM Unit Price Rate Amt Rate Amt Rate Amt Rate Amt

1 IN.B103 Battery Bank 48V600 AH VRLA 85072000 1 NOS 1,61,896.00 1,61,896 N/A N/A N/A N/A 0% - N/A N/A

Totals 1.00 1,61,896 - - - -

Delivery Challan Total (in figures) - Rupees 1,61,896
Delivery Challan Total (in words) - Rupees Rupees One Lakh SixtyOne Thousand Eight Hundred NinetySix Only

Receipt Confirmation No. of Box For ATC Telecom Infrastructure Pvt. Ltd.
I, hereby, acknowledging that above mentioned material is being received from Net Weight
transporter / Consignor With stamp

Name, Mobile No, Date & Signature of Recipient Authorized Signatory

Circle office Address : ATC Telecom Infrastructure Private Limited, 3rd Floor, IDCO Plot No. C-3/2,Chandaka Industrial Estate