RETURNABLE DELIVERY CHALLAN Original for Receipient Triplicate for Supplier

(Under Rule 10 of Goods and service Tax Rules, 2017) Duplicate for Transporter Extra Copy for Driver
Consignor : -
Unit no. 6 & 7, Om Anand Industrial Estate,
Raghunath Nagar, Thane (W) - 400 604
+91-9619394412 | +91-9820115959
rajesh@fourstarindustries.com | nikhil@fourstarin
www.fourstarindustries.com
Serial No. : 45OGST/FSI/04126 Mode Of Transport : BY ROAD E-WAY BILL DETAILS
Issue Date : 25-12-2022 ARN / ASN No. : E-Way Bill No.:
GSTIN No. : 27AAAFF8951F1ZD Place of Supply : THANE E-Way Bill Date.:
State : MAHARASHTRA State Code : 27
PAN No. : AAAFF8951F E-way Bill No. :

PART - A
Details of Receiver | Bill To: Details of Consignee | Ship To:
Name : HIGHTEMP FURNACES LTD Name : HIGHTEMP FURNACES LTD
Address : Gat No. 615, Kurli Near Chakan, Address : Gat No. 615, Kurli Near Chakan,
Pune - 410505 Pune - 410505

GSTIN No. : 27AAACH1727L1ZK Sup. Code : SUP/FSI/008 GSTIN No. : 27AAACH1727L1ZK Sup. Code : SUP/FSI/008
State : MAHARASHTRA State Code : 27 State : MAHARASHTRA State Code : 27
Sl No. Finish Part No. Description of Goods HSN Code Qty Unit Rate Currency Amount

1 1014 PAD RETAINER PLATE For HEAT TREATMENT 8708 750 Nos 105.00 Rs. 78,750.00

TRACEABILITY DETAILS
FSI heat Code : GRN01343 Steel Mill heat Code : B22-2447 RM Supplier heat Code : B22-2447

RNo : Note
:

Total Quantity. 750.00 Pcs Total Amount 78,750.00

Material ID : Total Amount Before Tax 78,750.00
Transporter Name : JEEVAN Add : SGST 9.00% 7,087.50
Vehicle No : MH04KF0030 Add : CGST 9.00% 7,087.50
Transport details : FSI TRANSPORT Add : IGST 0.00% 0.00
Mobile No. : 7709775585 Total Tax Amount : GST 14,175.00
Estimated Value of Goods (in words) Total Value of Supply After Tax 92,925.00
Rupees seventy-eight thousand seven hundred fifty Only GST Payable on Reverse Charge
GST Amount (in words ) Certified that the particulars given above are true and correct.
For , Four Star Industries
Rupees fourteen thousand one hundred seventy-five Only

Authorised Signatory
PLEASE NOTE: - Our Delivery Challan referance & Purchase order number should be mentioned while returning back the material alongwith Duplicate copy of Challan. Any
Discrepancies regarding quantity etc., are to be notified in writing within three days on receipts of the goods. Material shall return within one year in case of Input Material and
three year in case of capital goods.
PART - B
To be filled by Processing factory in duplicate of Challan on receipt of goods from processing factory
1. Date and time of dispatch of Processed goods to parent factory :
2. Entry no. and Date of Receipt in the account of processing factory :
3. Quantity ready for Dispatch :
4. Nature of Processing Done :
Signature of Processor / Jobworker
5. Quantity of waste materials returned to the parent factory, (Challan No. & :
Date) Name & Designation (with Rubber Stamp)
SUBJECT TO THANE JURISDICTION
This is a Computer Generated Invoice it does not Require Sign