Tax Invoice (Repair Order - Insurance)

CHENNAI FORD
SF- 267/2 POONAMALLEE BYE PASS, ROAD, POONAMALLEE, CHENNAI. CHENNAI. PIN - 600056. TAMILNADU. Ph - 9840053209,.. Fax: .. E-mail:
pnmmanager@chennaiford.com. CST No: .. LST No: .. PAN No:AANCS5267M. GSTIN:33AAACC4158L2ZO
1 of 1
Bill No. : 3711020202200050 Bill Dt. : 25-04-2022 RO No. : ROABM00287PN RO Dt. : 19-04-2022
Insurance Details : Customer Details : Dealer Address :
ACKO GENERAL INSURANCE LTD GANESH BABU M CHENNAI FORD
3RD FLOOR-EWING,301,LOTUS, COR 58 KRE LAYOUT, COLLEGE ROAD TIRUPUR,- CHENNAI
PARK,OFF WESTERN, EXPRESS HIGHMUMBAI 641602
State: TAMIL NADU, State Code: 33
MUMBAI CITY-400063 State: TAMIL NADU, State Code: 33
GSTIN/UID: 33AAACC4158L2ZO
Contact: 9500011121 (M) GSTIN/UID:
Email : nomail@gmail.com Party Code:CU099554
Place of Supply : MAHARASHTRA (27)
State: MAHARASHTRA, State Code: 27
GSTIN/UID: 27AAOCA9055C1ZJ
Party Code: ACKKO

Vehicle Details :
VIN : MAJGXXMTKGFM34633 Color : Silver KMS : 94670
Reg. No. : TN39BS2860 Catcode : ICH76BAD Make : New Figo
Engine No. : Category : Body & Paint Ins. Policy No. : 213232132105
Chassis No. : MAJGXXMTKGFM34633 Sales Date : 30-NOV-15 Ins. Valid From : 22-03-2021 To : 21-03-2023

Sl. Goods / Services HSN/SAC Qty. Rate Total Discount Taxable IGST CGST SGST
& (Per Item) Value
Description Rate Rate Amt. Rate Amt. Rate
Amt. Amt.
(%) (%) (%) (%)
Labour
Billable
1 BP-00434 Accident repair as p 00998729 1.00 2000.00 2000.00 .00 .00 2000.00 18.00 360.00 .00 .00 .00 .00
Parts
Billable
1 99SZ19562A SEALER WSHLD 32141000 1.00 1116.95 1116.95 .00 .00 1116.95 18.00 201.05 .00 .00 .00 .00
GLASS
2 E4BZ5803100A GLASS 70072190 1.00 3133.89 3133.89 .00 .00 3133.89 18.00 564.10 .00 .00 .00 .00
WINDSHIELD

Tax Summary Total Amount 6250.84

Total Taxable Value Tax Amount Discount Amount .00
IGST@18% (Labor) 2000.00 360.00 Total Taxable Amount 6250.84
IGST@18% (Parts) 4250.84 765.15
Total Tax Amount 1125.15

Total Payable 7375.99

Round Off .00

Net Payable (In Figure) 7375.99

Net Payable (In Words):-

Please Pay Seven Thousand Three Hundred And
Seventy Five & Ninety Nine Paise Only

I agree that you (Ford and or Dealer) may collect, store, handle and use data (personal, financial, others etc.) shared by me during the transactions for providing me
all services related to Ford products. I also allow you to transfer the data to your authorized associates located within or outside India.

For CHENNAI FORD

Sign. Of Customer Authorised Signatory