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Put Company name with address Office Address: Factory Address: TAX INVOICE CUM DELIVERY CHALLAN (Under

Rule II of C Excise Rule 2002) To, (Put Consignee name) Tax Invoice No.: Challan No: Order No...: Transporter....: L.R. No..: Pay Terms.:30 Days Prep. Date..: Removal Dt: Quantity Rate Per Original for Buyer Dt: Dt: Dt: Dt: Time: Time: Amount ( )

LST/TIN No.: CST No.: ECC No.: S No. Description of Goods Tarrif No.: Commodity Name: 1 (Mention description of goods with packing ) Net Amount Excise Duty @10.00% on Rs. Add: S.H.E. Cess @1.00% Add: Cess @ 2.00% C.S.T. @ 2% on Rs. (+/-) Round Off Gross Amount

Tot. No. of packages: Excise Value: Invoice Value: P.L.A. Entry No. : RG 23A Part II Ent. no. VAT TIN NO. CST TIN NO. Exc. Reg. no. Range: Division: Commissionorate:

Freight: To Pay / Paid Date: Date:


I/We hereby certify that my/our registration certificate under the Maharashtra Value Added Tax Act, 2002 is in force on the date on which the sale of goods specified in this 'Tax Invoice' is made by me/us and that the transaction of sale covered by this 'Tax Invoice' has been effected by me/us and it shall be accounted for in the turnover of sales while filing return and the due tax, if any, payable on the sale has been paid or shall be paid.

For (Put Company Name)

(Authorized Signatory)

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