GSTIN : 03AAKFJ3095J1Z7 Original Copy

TAX INVOICE
JAIN AUTOMOBILES
THANDI SADAK,NEAR TRUCK UNION, MALERKOTLA,DIST.SANGRUR
PUNJAB-148023

Invoice No. : 101809 Place of Supply : Punjab (03)

Date of Invoice : 16-11-2019 Reverse Charge : N

Billed to : Shipped to :
BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD. PARMJIT SINGH
SANDHU TOWERS,5TH FLOOR,B-XX-3369, PB 28 G 3154
GURDEV NAGAR,FEROZEPUR ROAD,LUDHIANA

GSTIN / UIN : 03AABCB5730G1Z7 GSTIN / UIN :

S.N. Description of Goods HSN/SAC Qty. Unit Price CGST CGST SGST SGST Amount( ` )
Code Rate Amount Rate Amount

1. PANEL FR TOP+TAPESET TIT GREY 87141090 1.00 Pcs. 1,015.62 14.00 % 142.19 14.00 % 142.19 1,300.00
2. HEADLAMP ASSY 73181190 1.00 Pcs. 622.88 9.00 % 56.06 9.00 % 56.06 735.00
3. HOUSING HEADLAMP FR T GREY 87141090 1.00 Pcs. 527.34 14.00 % 73.83 14.00 % 73.83 675.00
4. SPEEDOMETER 90292020 1.00 Pcs. 1,144.06 9.00 % 102.97 9.00 % 102.97 1,350.00
5. SIDE PANEL RH+TAPESET TIT.GREY 87141090 1.00 Pcs. 1,285.16 14.00 % 179.92 14.00 % 179.92 1,645.00
6. LABOUR 9987 1.00 Units 450.00 9.00 % 40.50 9.00 % 40.50 531.00

Grand Total 6.00 Units ` 6,236.00

Tax Rate Taxable Amt. CGST SGST Total Tax

28% 2,828.12 395.94 395.94 791.88
18% 2,216.94 199.53 199.53 399.06
Totals 5,045.06 595.47 595.47 1,190.94

Rupees Six Thousand Two Hundred Thirty Six Only

Terms & Conditions Receiver's Signature :

E.& O.E.
1. Goods once sold will not be taken back.
2. Interest @ 18% p.a. will be charged if the payment For JAIN AUTOMOBILES
is not made with in the stipulated time.
3. Subject to 'MALERKOTLA' Jurisdiction only.
Authorised Signatory