DELIVERY CHALLAN

[Issued Under Rule 55(1)(c) of GST Rules] (ORIGINAL FOR CONSIGNEE)

Delivery Challan No Delivery Challan Date

Consignor (Dealer Code) 0002089314 Consignor Name SHREE BALAJI SERVICES
Consignor Address Consignor GSTIN
Consignee Name Consignee GSTIN
Consignee Address
Packing Slip No. 2P0002089314102024 Packing Slip Date 27-03-2024
Packing Slip Category Short Receipt Status Pending with Dealer
Place of Supply Road Permit No
Consignment Value 12645.82 Dispatched Cases
Total No. of Prowacs 7 Total Number of Parts 3
Dealer Remarks

Index--> UQ= Used Quantity, PQ= Perished Quantity, SFQ= Short Fitment Quantity, DQ= Dispatch Quantity

Sr. Prowac Prowac

Chassis No. KMs Part No. Part Description HSN Code UQ PQ SFQ DQ Taxable Value Case Nos.
No. No. Year
1 04490 2023 MAT563009N7D10374 067980 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
2 04503 2023 MAT843003P7C06784 054131 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
3 04508 2023 MAT563011N7H20056 066113 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
4 04521 2023 MAT563010N7N27441 071489 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
5 04526 2023 MAT563013N7J21715 131947 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
6 04555 2023 MAT563010N7P28571 079469 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
7 04589 2023 MAT563011N7G16661 061268 554749200107 UREA TANK ASSY 8708.99.00 1 0 0 3307.38

Signature : ________________________________

Print Date : Apr 11, 2024, 2:54 PM 1 / 3

 DELIVERY CHALLAN
[Issued Under Rule 55(1)(c) of GST Rules] (DUPLICATE FOR TRANSPORTER)

Delivery Challan No Delivery Challan Date

Consignor (Dealer Code) 0002089314 Consignor Name SHREE BALAJI SERVICES
Consignor Address Consignor GSTIN
Consignee Name Consignee GSTIN
Consignee Address
Packing Slip No. 2P0002089314102024 Packing Slip Date 27-03-2024
Packing Slip Category Short Receipt Status Pending with Dealer
Place of Supply PUNE Road Permit No
Consignment Value 12645.82 Dispatched Cases
Total No. of Prowacs 7 Total Number of Parts 3
Dealer Remarks

Index--> UQ= Used Quantity, PQ= Perished Quantity, SFQ= Short Fitment Quantity, DQ= Dispatch Quantity

Sr. Prowac Prowac

Chassis No. KMs Part No. Part Description HSN Code UQ PQ SFQ DQ Taxable Value Case Nos.
No. No. Year
1 04490 2023 MAT563009N7D10374 067980 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
2 04503 2023 MAT843003P7C06784 054131 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
3 04508 2023 MAT563011N7H20056 066113 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
4 04521 2023 MAT563010N7N27441 071489 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
5 04526 2023 MAT563013N7J21715 131947 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
6 04555 2023 MAT563010N7P28571 079469 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
7 04589 2023 MAT563011N7G16661 061268 554749200107 UREA TANK ASSY 8708.99.00 1 0 0 3307.38

Signature : ________________________________

Print Date : Apr 11, 2024, 2:54 PM 2 / 3

 DELIVERY CHALLAN
[Issued Under Rule 55(1)(c) of GST Rules] (TRIPLICATE FOR CONSIGNOR)

Delivery Challan No Delivery Challan Date

Consignor (Dealer Code) 0002089314 Consignor Name SHREE BALAJI SERVICES
Consignor Address Consignor GSTIN
Consignee Name Consignee GSTIN
Consignee Address
Packing Slip No. 2P0002089314102024 Packing Slip Date 27-03-2024
Packing Slip Category Short Receipt Status Pending with Dealer
Place of Supply PUNE Road Permit No
Consignment Value 12645.82 Dispatched Cases
Total No. of Prowacs 7 Total Number of Parts 3
Dealer Remarks

Index--> UQ= Used Quantity, PQ= Perished Quantity, SFQ= Short Fitment Quantity, DQ= Dispatch Quantity

Sr. Prowac Prowac

Chassis No. KMs Part No. Part Description HSN Code UQ PQ SFQ DQ Taxable Value Case Nos.
No. No. Year
1 04490 2023 MAT563009N7D10374 067980 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
2 04503 2023 MAT843003P7C06784 054131 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
3 04508 2023 MAT563011N7H20056 066113 570615400104 SENSOR,UREA QUALITY 8708.99.00 1 0 0 649.48
4 04521 2023 MAT563010N7N27441 071489 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
5 04526 2023 MAT563013N7J21715 131947 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
6 04555 2023 MAT563010N7P28571 079469 570615400101 NOX SENSOR 9027.10.00 1 0 0 2463.33
7 04589 2023 MAT563011N7G16661 061268 554749200107 UREA TANK ASSY 8708.99.00 1 0 0 3307.38

Signature : ________________________________

Print Date : Apr 11, 2024, 2:54 PM 3 / 3