Dhingra Publishing House

37/2/14, Site IV, Sahibabad Industrial Area, Ghaziabad, U.P Ph: 0120 4159990, 4123818, Tele fax: 0120 4159990
NECC/ADMIN/T/E-DEL/00

Phone/E-mail Delivery Request Form

Date : 26/11/11

Consignor :

M/s. Dhingra Publishing House Contact Person : Hargobind Dhingra Desiganation : Director/Partner/Proprietor/Manager Authorised Signatory Phone /Mobile No 9899539990 M/s. Mangal Book House Contact Person : Designation: Authorised Signatory Phone /Mobile No Mr. ANIL SHARMA Director/Partner/Proprietor/Manager

Consignee :

Ref.:

CN No. (with Code & Pkg)

16-10415822,28/9/2011 16/10450413,30/10/2011 28/9/2011 30/10/2011

Date

Destination Documents Received Detail

(Tick Mark)

IMPHAL

We are submiting the Original GR/Bond to you alongwith this request format for accounting purpose as per our talk.. Please deliver the goods on our Risk & Responsibilities against your freight & other charges.

Applicant Name: Hargobind Dhingra Contact No.(Phone/Mobile) :9899539990

Inter Office Use Only

Ref. No.:_________________

Inform to Branch Office (Through...<TickMark>) Remarks :

Phone Call E-mail

Delivery Detail Gate Pass No. :__________________ Date :_________________________ Freight Rs.______________________ Case File on Dated :_____________