Original for Buyer

EXCISE INVOICE
(ISSUE OF INVOICE UNDER RULE 11 OF CENTRAL EXCISE RULES 2002)

G. Surgiwear Limited (Unit-2)

Hathouda Bujurg Shahjahanpur-242 001, Uttar Pradesh, India
Phone: 05842-671407 / E-Mail: surgiwear@hotmail.com
C.I.N. No.
VAT TIN
CST NO.
Drug Mfg Lic.No.

U24236UP1990PLC012073
09909300545
SJ 5043766 DT.4-4-91

Excise Regn No.

Range
Division
Commissionerate

M/S Pragya Medical Agency

PP Tower, Kanpur Road, Veerangana Nagar
Jhansi-284 001,Uttar Pradesh - India
Phone No. - (05174) 2321755, 09415060020
TIN No. - 09432407691
CST No. ECC No. DL No.
- 1557/20B/2010, 1557/21B/2010

Sr.

For G. Surgiwear Limited (Unit-2)

Authorised Signatory

Invoice No. U2/002464

Order No.
SO/SB/U2/00438
External Doc No. 82
Transporter Name
Destination
Despatch Through
Vehicle No.
L/R No.
Date & Time of Issue of Invoice
Date & Time of Issue of Goods
Mode/Term of Payment

Consignee/Customer:

Product

No. Description of Goods

1 Plain Towel
Batch No.-1408BC0 Mfg.Dt.-Sep 14 Exp.Dt.-Jul 19 Qty-200
2 Eye Drape Eco
Batch No.-1409AD0 Mfg.Dt.-Sep 14 Exp.Dt.-Aug 19 Qty-200
3 G-Kit
Batch No.-1408BB0 Mfg.Dt.-Aug 14 Exp.Dt.-Jul 19 Qty-10

Authenticated By

AAACG7035JEM004
SHAHJAHANPUR
SITAPUR
LUCKNOW

Code

Tarrif

Rate Per SD*/

Heading UOM QTY.

Dated
Dated

Jhansi

Dated
13-10-14 - 13:33:59
13-10-14 - 13:33:59

Total

Unit

CD**

13-10-14
13-10-14

Assessa Assessable BED

Value -ble Rate

BED

Value

Amount

D303 9018.90.99

NO.

200

22.30

0/2

4,370.80

21.85

4,370.80

262.25

E711 9018.90.99

NO.

200

38.59

0/2

7,563.64

37.82

7,563.64

453.82

K004 9018.90.99

NO.

10

368.74

0/2

3,613.65

361.37

3,613.65

216.82

410

Total

15,548.09

15,548.09

932.89

Total Value (INR)

15,548.09
932.89
18.66
9.33

Amount in words :(INR)

Basic Excise Duty

E Cess
SHE Cess
Tax Base Amount
VAT
SAT
Total Charges
Round off

**** SEVENTEEN THOUSAND THREE HUNDRED THIRTY FOUR RUPEES AND FORTY TWO PAISA ONLY

Total INR Incl. Taxes

Total Duty Payable (in Words):(INR)

**** NINE HUNDRED SIXTY RUPEES AND EIGHTY EIGHT PAISA ONLY

Comment :

SD*- Scheme Discount %

CD**- Cash discount %

16,508.97
4.00%
1.00%

660.36
165.09
0.00
0.00

17,334.42

Declaration : We declare that this Invoice shows the actual price of the goods described and that all particulars are true and correct.
Pre Authenticated By

E. & O.E.

For G. Surgiwear Limited (Unit-2)

Authorised Signatory

This is a Computer Generated Invoice