Correctional Sales Invoice Page 1of 1

Seller Pepsi-Cola General Exporter Pepsi-Cola General Billing Number 573150302 Internal Bill To
Bottlers Poland Sp. z o.o. Bottlers Poland Sp. z o.o. Reference # 2003021690

Address Plac Konesera 12 Address Plac Konesera 12 Billing Date 22/02/2024 Seller's Reference # 6500838814
Warszawa Warszawa
03-736 Warszawa 03-736 Warszawa Currency PLN Customer Reference #
Poland Poland
Payment Term Net due in 30 days Payment Due Date 23/03/2024

Company Reg. No. 0000097597 Company Reg. No. 0000097597 Doc. Created 23/02/2024

VAT Number PL5260210530 VAT Number PL5260210530

Payer UAB KALNAPILIO- Sold To UAB KALNAPILIO- Ship To / UAB "KALNAPILIO-

TAURO GRUPE TAURO GRUPE Consignee TAURO GRUPE"

Address TAIKOS AL. 1 Address TAIKOS AL. 1 Address J. JANONIO G. 30

LT-35147 PANEVĖŽYS LT-35147 PANEVĖŽYS LT-35289 PANEVĖŽYS
Lithuania Lithuania Lithuania

VAT Number LT219581219 VAT Number LT219581219 Tax Number

EORI Number Reference Invoice 572004796

Vessel Port of Loading Ref. Invoice Date 22/02/2024

Destination Country Lithuania Incoterms FCA FCA Port of Discharge Reason for Correction Sales Order Errors

HS Code Unit Price

Country Net Value Gross Value Correction
Line # Product Code Product Description Meursing UoM Quantity (excl. VAT & VAT %
of Origin (excl. VAT) (incl. VAT) Reference
Legacy Code Code Discount)

10 1100000046 CRATE 200ML NB WITH 44152020 EA 768,00 18,60 14 284,80 0% 14 284,80

231 BOTTLE

20 1200000185 PALLET WOOD 1200X800 PL 44152020 EA 26,00 29,96 778,96 0% 778,96

10999
30 300038024 PEPSI COL COLA GRB PL 22021000 CS 768,00 2,12 1 628,16 0% 1 628,16
200ML 1P24C 7G BA AXL

40 300040773 PEPSI ZS COLA GRB 200ML PL 22021000 CS 480,00 6,95 3 336,00 0% 3 336,00
1PK24CS BAL

Total 20 027,92 To Refund 20 027,92

Amount of Correction ( Difference )

Net Value Gross Value Gross Weight Net Weight Cubic volume
Summary VAT
(excl. VAT) (Incl. VAT) (KG) (KG) ( m3 ) Place of Issue
VAT 0% 0,00 20 027,92 20 027,92 16 990,160 6 829,328 41,054
Total 0,00 20 027,92 20 027,92
Date of Issue
Supply of goods mentioned in art. 138 s. 1 Council Directive
2006/112/EC
Name of
Representative
Stamp:
Signature

THE EXPORTER OF THE PRODUCTS COVERED BY THIS DOCUMENT (CUSTOMS Date of

AUTHORIZATION No………..………) DECLARES THAT EXCEPT WHERE OTHERWISE Signature
CLEARLY INDICATED, THESE PRODUCTS ARE OF PL PREFERENTIAL ORIGIN.

Remit Payment To

Bank transfer on Acc. No:

Przelew bankowy na konto Nr.
PL45103015080000000500644001
BANK HANDLOWY W WARSZAWIE Terms and Conditions
S.A.