Reliance Retail Limited

5th Floor, 89, A-1 Towers, DR. Radhakrishna Salai,

Mylapore, Chennai Tamil Nadu 600004

(Original for Recipient)

Tax Invoice

Invoice No : A9R23R9995191355 Invoice/Payment Date & Time : 06 Dec,2022 21:04:32

PAN No : AABCR1718E GST No : 33AADCR6715M1Z6

Order Ref. No. : TB000029CETC Payment Ref. No. : 221206381604122681

Mode of Payment : Debit Card

Customer Name : Poojendra U Place of Supply : 33 Tamil Nadu

Customer Address : 4/618 - 27, Onnipalayam road, near dinesh mill
Jio Number : 1317960249
sri angalammanpuram, bilichi, Coimbatore,
641019

Sr. Taxable
Item Name HSN/SAC Qty MRP/Unit( `) Discount( `)
No. Amount( `)

1 JioFiber_1M_999 998422 1 1,070.82 0.00 999.00

Total Taxable Amount 999.00

CGST (9%) 35.91

SGST (9%) 35.91

Total Amount( `) 1,070.82

Total Amount (in words) Four Hundred Seventy Rupees Eighty Two Paisa Only
Telecommunication services to be provided by Reliance Jio Infocomm Limited
Platform services to be provided by Jio Platforms Limited
All disputes are subjected to Mumbai Jurisdiction
Tax is not payable under Reverse Charge basis for this supply.

Declaration : Certified that all the particulars given above are true and correct

Digitally signed by DS RELIANCE RETAIL LIMITED

Date: 2022.12.29 14:56:32 IST
Reason: Invoice
Location: 33 Tamil Nadu

Digital Signature

Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
CIN: U01100MH1999PLC120563 www.relianceretail.com
 Reliance Retail Limited

5th Floor, 89, A-1 Towers, DR. Radhakrishna Salai,

Mylapore, Chennai Tamil Nadu 600004

(Original for Recipient)

Payment Receipt

Payment Receipt No : TB000029CETC Date : 06 Dec,2022 21:04:32

Order Ref No : TB000029CETC

Customer Name : Poojendra U Customer Address : 4/618 - 27, Onnipalayam road, near dinesh mill,
sri angalammanpuram, bilichi, Coimbatore, 641019
Jio Number : 1317960249

Sr. No. Plan Details Qty MRP/Unit( `) Total( `)

1 JioFiber_1M_999 1 1,070.82 1,070.82

Total Amount ( `) 1,070.82

Total Amount (in words) Thousand Seventy Rupees Eighty Two Paisa Only

Declaration : Certified that all the particulars given above are true and correct.

This is a computer generated payment receipt, hence does not require signature.

Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
CIN: U01100MH1999PLC120563 www.relianceretail.com

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