Tax Invoice (ORIGINAL FOR RECIPIENT)

Devikrupa Soft Drinks Invoice No. Dated

Plot No.3231,3232,3233,3334 326 29-Apr-22
G. Gandapalli, Rambha Delivery Note Mode/Terms of Payment
Ganjam 326
GSTIN/UIN: 21AYAPP2019E1Z4
State Name : Odisha, Code : 21 Reference No. & Date. Other References
E-Mail : devikrupasoftdrink@gmail.com
Buyer’s Order No. Dated
Consignee (Ship to)
OM Agency Dispatch Doc No. Delivery Note Date
Khariar Road, Nuapada 326 29-Apr-22
GSTIN/UIN : 21BTOPJ3292F1ZQ Dispatched through Destination
State Name : Odisha, Code : 21 By Road
Bill of Lading/LR-RR No. Motor Vehicle No.
Buyer (Bill to) MP-09GF-4164
OM Agency Terms of Delivery
Khariar Road, Nuapada
GSTIN/UIN : 21BTOPJ3292F1ZQ
State Name : Odisha, Code : 21

Sl Description of Goods HSN/SAC Quantity Rate per Amount

No.

1 BIT Lemon Juice 200 ML 22029920 1,910 Box 115.00 Box 2,19,643.00

CGST @6% 6 % 13,178.58

SGST @6% 6 % 13,178.58
Less : Round Off (-)0.16

Total 1,910 Box 2,46,000.00

Amount Chargeable (in words) E. & O.E
INR Two Lakh Forty Six Thousand Only
HSN/SAC Taxable Central Tax State Tax Total
Value Rate Amount Rate Amount Tax Amount
22029920 2,19,643.00 6% 13,178.58 6% 13,178.58 26,357.16
Total 2,19,643.00 13,178.58 13,178.58 26,357.16

Tax Amount (in words) : INR Twenty Six Thousand Three Hundred Fifty Seven and Sixteen paise Only

Declaration for Devikrupa Soft Drinks

We declare that this invoice shows the actual price of the
goods described and that all particulars are true and correct.
Authorised Signatory

This is a Computer Generated Invoice