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December 15
December 15
FORM - C
To TIN 36200212844
CST HYR/02/3/2370/99-2000
Name SHYAM PHENO CHEM PVT LTD
Address of seller HYDERABAD
It is further certified that I/we am/are not registered under section 7 of the said Act in the State of
TELANGANA in which the goods covered by this Form are/will be delivered.
Name and address of the purchasing dealer SONA META CHEM PVT LTD
in full R.S. NO 9/13, KARASUR VILLAGE, KADAPERIKUPPAM POST,
PUDUCHERRY-605502
Date : Signature
NOTE :- Counterfoil - to be retained by the purchasing dealer; Duplicate - to be retained by the selling dealer.
[ Original to be furnished to the prescribed authority in accordance with the rules framed under sec 13(4)(e) by the
appropriate State Government.]
Genuineness of this form can be verified through the official website http://gst.puducherry.gov.in using
web reference number 1914261 or http://www.tinxsys.com
[THIS FORM SHOULD BE IN TRIPLICATE AS * COUNTERFOIL * DUPLICATE * ORIGINAL]
Signature
Name of the person signing the declaration : D K SHARMAA
Status of person signing declaration in relation to the dealer :MANAGING DIRECTOR