Reliance Retail Limited

Office Block No.1, 3rd Floor, DB City Mall, Arera , Hills, MP

Nagar, Bhopal, Madhya Pradesh, Bhopal, Madhya Pradesh,
462016

(Original for Recipient)

Tax Invoice

Invoice No : 23R23I0008028543 Invoice/Payment Date & Time : 06 Jun,2022 21:16:34

PAN No : AABCR1718E GST No : 23AABCR1718E1ZX

Order Ref. No. : BR0007TFQC0V Payment Ref. No. : 215721626331

Mode of Payment : Credit Card

Customer Name : Shivam Mishra Place of Supply : 23 Madhya Pradesh

Jio Number : 9174319941 Address : ward number 04, lal bahadur shastri
ward,WARD NUMBER 04,near ram mandir, lal
bahadur shastri ward, Madhya Pradesh,

Sr. Taxable Amount( `)

Plan Details SAC Qty MRP/Unit( `) Discount( `)
No.

1 MRP 121 998413 1 121.00 0.00 102.54

Total Taxable Amount 102.54

CGST (9%) 9.23

SGST (9%) 9.23

Total Amount 121.00

Total Amount (in words) One Hundred Twenty One Rupees Only

Telecommunication services to be provided by Reliance Jio Infocomm 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

Authorized Signatory
Digitally signed by DS RELIANCE RETAIL LIMITED
Date: 2022.07.12 00:07:43 IST
Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
Reason: Invoice
Location: 23 Madhya Pradesh
CIN: U01100MH1999PLC120563 www.relianceretail.com