Rice Miller Claim Bill Form

(FORTIFIED RM BILL)

Agency Name :WBECSC District :HOOGHLY

KMS 2022-2023 Name of the Rice Mill MADINA RICE MILL P LTD.
Claim No F222308360342 Type of the Rice Mill Perboiled
Claim Submission Date 22/01/2024 GSTN 19AAGCM9430R1ZM
Total Claim Amount(in Rs.) 1,88,338.61 PAN AAGCM9430R
Pool State Contact No 9474402511
Mail madina.fkm@gmail.com
Bank A/C No 50105832972
IFSC IDIB000A649

RRO NO RRO Date e-WQSC No e-WQSC Paddy Resultant FRK added Final CMR
Approval date Quantity(Qtl.) CMR(Qtl.) (Qtl) quantity(Qtl)
HGL/ECS/0836/2324439 12/09/2023 2022- 15/09/2023 3794.09000 2579.98120 25.79981 2605.78101
23/338/4207
Total (in Qtl.) 3794.09000 2579.98120 25.79981 2605.78101

Claim Towards the Cost of Fortified Rice Kernel Purchased for the KMS 2022-2023

Particulars Rate/Qtl (in Rs.) Quantity (in Qtl) Total Amount (in
Rs.)
Charges for FRK 73.00 2579.98100 188338.6130000
Gross Claim (in Rs.) 188338.6130000
Gross Claim (Round off in whole rupees)(in Rs.) 188339
(Rupees: One Lakh Eighty Eight Thousand Three Hundred Thirty Nine Rupees only)

Declaration : I declare that the claim have not been submitted/drawn previously either manually or through e-Mode.If any amount is
found to be paid in excess shall be refunded or adjusted from next bills.

Name of Rice Miller : MADINA RICE MILL P LTD.