‫ﺍﻟﻔﺎﺗﻮﺭﺓ ﺍﻟﻤﻮﺣﺪﺓ ﻟﻀﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬

‫‪Simplified Tax Invoice‬‬

‫‪Issue Date‬‬ ‫‪2023-12-11‬‬ ‫ﺗﺎﺭﻳﺦ ﺍﻻﺻﺪﺍﺭ‬
‫‪Invoice Number‬‬ ‫‪ARB20231130R0161003366‬‬ ‫ﺭﻗﻢ ﺍﻟﻔﺎﺗﻮﺭﺓ‬
‫‪VAT Number of Supplier‬‬ ‫‪300000434710003‬‬ ‫ﺭﻗﻢ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬
‫‪For the period‬‬ ‫‪2023-11-01 - 2023-11-30‬‬ ‫ﻟﻠﻔﺘﺮﺓ‬

‫‪Seller‬‬ ‫ﺍﻟﻤﻮﺭﺩ‬ ‫‪Buyer‬‬ ‫ﺍﻟﻌﻤﯩﻞ‬

‫‪Name‬‬ ‫ﺷﺮﻛﺔ ﺍﻟﺮﺍﺟﺤﻲ ﺍﻟﻤﺼﺮﻓﻴﺔ ﻟﻼﺳﺘﺜﻤﺎﺭ‬ ‫ﺍﺳﻢ‬ ‫‪Name‬‬ ‫ﻧﻮﺍﻑ ﻋﺎﻳﺾ ﻣﺸﻠﺢ ﺍﻟﺤﺴﺎﻭﻱ ﺍﻟﺪﻭﺳﺮﻱ‬ ‫ﺍﺳﻢ‬
‫‪Street Name‬‬ ‫ﻃﺮﻳﻖ ﺍﻟﻤﻠﻚ ﻓﻬﺪ‬ ‫ﺍﺳﻢ ﺍﻟﺸﺎﺭﻉ‬ ‫‪Street Name‬‬ ‫‪Wadi Al Summan‬‬ ‫ﺍﺳﻢ ﺍﻟﺸﺎﺭﻉ‬
‫‪Building No‬‬ ‫‪8467‬‬ ‫ﺭﻗﻢ ﺍﻟﻤﺒﻨﻰ‬ ‫‪Building No‬‬ ‫‪4045‬‬ ‫ﺭﻗﻢ ﺍﻟﻤﺒﻨﻰ‬
‫‪City‬‬ ‫ﺍﻟﺮﻳﺎﺽ‬ ‫ﻣﺪﻳﻨﺔ‬ ‫‪District‬‬ ‫‪Al Qadisiyah Dist.‬‬ ‫ﺍﻟﺤﻰ‬
‫‪Country‬‬ ‫ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ‬ ‫ﺑﻠﺪ‬ ‫‪City‬‬ ‫ﺍﻟﺮﻳﺎﺽ‬ ‫ﻣﺪﻳﻨﺔ‬
‫‪Postal Code‬‬ ‫‪12263‬‬ ‫ﺍﻟﺮﻣﺰ ﺍﻟﺒﺮﻳﺪﻱ‬ ‫‪Country‬‬ ‫ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ‬ ‫ﺑﻠﺪ‬
‫‪District‬‬ ‫ﺣﻲ ﺍﻟﻤﺮﻭﺝ‬ ‫ﺍﻟﺤﻰ‬ ‫‪Postal Code‬‬ ‫‪13252‬‬ ‫ﺍﻟﺮﻣﺰ ﺍﻟﺒﺮﻳﺪﻱ‬
‫‪VAT Number‬‬ ‫‪300000434710003‬‬ ‫ﺭﻗﻢ ﺗﺴﺠﻴﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ‬ ‫‪VAT Number‬‬ ‫ﺭﻗﻢ ﺗﺴﺠﻴﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ‬
‫ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻤﻀﺎﻓﺔ‬
‫‪Other Seller ID:‬‬ ‫)‪1010000096 (CRN‬‬ ‫ﻣﻌﺮﻑ ﺁﺧﺮ‬ ‫‪Other Buyer ID:‬‬ ‫)‪11246926720 (NAT‬‬ ‫ﻣﻌﺮﻑ ﺁﺧﺮ‬

‫‪Line Items:‬‬ ‫ﺗﻮﺻﻴﻒ ﺍﻟﺴﻠﻌﺔ ﺍﻭ ﺍﻟﺨﺪﻣﺔ‬

‫ﺭﻗﻢ‬ ‫ﻭﺻﻒ ﺍﻟﺒﻨﺪ‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﺘﻮﺭﻳﺪ‬ ‫ﻛﻤﻴﺔ‬ ‫ﺇﺟﻤﺎﻟﻲ ﺑﺪﻭﻥ ﺿﺮﻳﺒﺔ‬ ‫ﻧﺴﺒﺔ‬ ‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ‬ ‫ﺍﻟﻤﺠﻤﻮﻉ ﺭ‪.‬ﺱ‬ ‫ﻣﻼﺣﻈﺎﺕ‬
‫ﻣﺘﺴﻠﺴﻞ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻀﺮﻳﺒﺔ‬ ‫ﺍﻟﻤﻀﺎﻓﺔ ﺭ‪.‬ﺱ‬
‫‪Service Description‬‬ ‫‪Date of‬‬ ‫‪Quantity‬‬ ‫‪Total Amount in‬‬ ‫‪Remarks‬‬
‫‪SL. No‬‬ ‫‪Supply‬‬ ‫‪Total Price excl.‬‬ ‫‪VAT%‬‬ ‫‪VAT Amount in‬‬ ‫‪SAR‬‬
‫‪VAT‬‬ ‫‪SAR‬‬

‫‪1‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-13‬‬ ‫‪1‬‬ ‫‪0.50‬‬ ‫‪15‬‬ ‫‪0.08‬‬ ‫‪0.58‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪2‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-20‬‬ ‫‪1‬‬ ‫‪0.50‬‬ ‫‪15‬‬ ‫‪0.08‬‬ ‫‪0.58‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪3‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-21‬‬ ‫‪1‬‬ ‫‪1.00‬‬ ‫‪15‬‬ ‫‪0.15‬‬ ‫‪1.15‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪4‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-27‬‬ ‫‪1‬‬ ‫‪0.50‬‬ ‫‪15‬‬ ‫‪0.08‬‬ ‫‪0.58‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪5‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-28‬‬ ‫‪1‬‬ ‫‪0.50‬‬ ‫‪15‬‬ ‫‪0.08‬‬ ‫‪0.58‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪6‬‬ ‫‪IPS TRANSACTION FEE‬‬ ‫‪2023-11-29‬‬ ‫‪1‬‬ ‫‪0.50‬‬ ‫‪15‬‬ ‫‪0.08‬‬ ‫‪0.58‬‬
‫ﺭﺳﻮﻡ ﺗﺤﻮﻳﻞ ﺳﺮﻳﻊ‬

‫‪Total‬‬ ‫‪3.50‬‬ ‫‪0.55‬‬ ‫‪4.05‬‬

‫‪Total amounts:‬‬ ‫ﺇﺟﻤﺎﻟﻲ ﺍﻟﻤﺒﺎﻟﻎ‬

‫)‪Total (Excluding VAT‬‬ ‫ﺍﻻﺟﻤﺎﻟﻲ ﺑﺎﺳﺘﺜﻨﺎﺀ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫‪3.50‬‬
‫‪Total Discount Amount‬‬ ‫ﺇﺟﻤﺎﻟﻲ ﻣﺒﻠﻎ ﺍﻟﺨﺼﻢ‬ ‫‪0.00‬‬
‫‪Total VAT‬‬ ‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫‪0.55‬‬
‫‪Total Amount Due‬‬ ‫ﻣﺠﻤﻮﻉ‬ ‫‪4.05‬‬

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