TAX INVOICE
Issued under GST Invoice Rules
Original: For Recipient
Duplicate : ForTransporter
Triplicate : For Supplier
IRN:1f7d6f5dc01eb8a60f44f940b1253f32383efd934040793dd9cacd3eaf103523
IRN Ack No:122528540789223
IRN Ack Date:10/09/2025
Customer Details Vehicle /Order Details
Invoice No : ISHRAU2526000794
Invoice Date : 10/09/2025
JALGAON MOTORS JobCard/SalesOrderNo.:OTC-ShrIni-AA1-2526- 000470
YELGAON, JobCard/SalesOrderDate:10/09/2025 Customer
UMAKANT PANDURANG KHEDKAR P.O. No :
CHICKHLIROADSUNDERKHEDBULDHANA, PaymentMethod:CASH Model
BULDHANA. Name :
BULDHANA BULDHANA Kms :
Maharashtra(27)India. Hrs :
Pin - 443001 Chassis # : MAT464212HSP16152
PhoneNo(Off,Fax):9860606020, A/C InsuranceCo:
Code : 1-1OAC72UU InsuranceType:
TenderNumber: PAN Insurance Expiry Date :
: Reg No :MH28BB0430
Transporter Name:
Dealer PAN: AEFFS0313B
Dealer GSTIN :27AEFFS0313B1ZN
Sales Executive: BHUSHAN MAHAJAN
Billing Address Shipping Address
CHICKHLIROADSUNDERKHEDBULDHANA CHICKHLIROADSUNDERKHEDBULDHANA
BULDHANA BULDHANA
BULDHANA, BULDHANA BULDHANA, BULDHANA
Maharashtra,India Maharashtra,India
Pin - 443001 Pin - 443001
Place of Supply: 27-Maharashtra
CustomerGSTIN:27BGSPK1102L3Z8
Dis CGST SGST/UTGST
S Schem Base cA Disc Taxable Total
HSN Part # Particulars Type UoM Qty Rate MRP Rate Rate
No eDisc Disc mt % Amt Amount Amount Amt
% %
ASSY.HEAD
28965440010 LAMP 3,440.6 4,060.0
1 8512.20.10 Paid Each 1 0 0 0 3,440.68 9 309.66 9 309.66 4,060.00
2 W/BLINKRH 8 0
RHD BS1/3/4
ASSY
28948810010 4,645.3 5,946.0
2 8708.99.00 FENDER Paid Each 1 0 0 0 4,645.31 14 650.34 14 650.34 5,946.00
4 1 0
OUTER
COMPLETE
RH
ASSY.FRTB
UMPER
28948850010 2,423.4 3,102.0
3 8708.29.00 PLASTICW_ Paid Each 1 0 0 0 2,423.44 14 339.28 14 339.28 3,102.00
9 4 0
BKTSBS1/3/4
Sub Total: 10,509.43
Total Tax Amount : 2,598.57
Net Taxable Amount: 10,509.43
@ 9% CGST on Parts: 309.66
@ 9% SGST on Parts: 309.66
@ 14% CGST on Parts: 989.62
@ 14% SGST on Parts: 989.62
Gross Amount : 13,108.00
Adjustments : 0.00
Grand Total : 13,108.00
RupeesThirteenThousandOne Hundred
Eight Only.
Loyalty Info:
Member # : xxxxx Tier #: Balance Points :
Note:
DearLoyaltyMember,youhaveearnedpointsonthistransactionofRs13,108.00.ThesepointswouldbecreditedtoyourLoyaltyAccount(xxxxx) once the
transaction is processed. You can Redeem your points when you get your vehicle serviced next time. Or call 1800 209 8188/1800 209 7979 to
redeem for exciting gifts. Contact dealer Loyalty Desk or visit www.tatamotorsease.com/www.tatadelight.comfor more details.
Tax Payable Under Reverse Charge - No
Termsand Conditions : E. & O. E.
1) Goods once sold will not be taken back.
2) Only the courts of KHAMGAON shall have jurisdiction in any proceedings relating to this contract.
3) IhaveinspectedthevehicleMH28BB0430andtakendeliveryofthevehicleonlyafterbeingsatisfiedregardingthemaintenanceworkcarriedoutinthevehicle.I do not have
any grievances/complaints pertaining to the chassis no MAT464212HSP16152.
4) I hereby consent and authorize SHRINIWAS VEHICLES INDIA LLP / KHAMGAON and Tata Motors Limited for usage of all the data disclosed above and also to
shareallmydetailsanddocumentsforpromotional,marketingandtransactionalactivitiesofTataMotorsLtd.oranyofitsgroupcompanies/subsidiaries/authorized dealers, in
accordance with Tata Motor's Privacy Policy. I shall inform in writing to Tata Motors Limited, if I intend to withdraw my aforesaid consent.
Vehicle / Goods received in good condition and to our satisfaction..
For SHRINIWAS VEHICLES INDIA LLP
Customer's Signature Authorized signatory
SHRINIWAS VEHICLES INDIA LLP
*GATE PASS*
Account Name : UMAKANT PANDURANG KHEDKAR Invoice Ref. : ISHRAU2526000794 dated
10/09/2025
Vehicle No : MH28BB0430 Invoice Amount : Rs. 13,108.00
Chassis No : MAT464212HSP16152 Job Card / Order ref : OTC-ShrIni-AA1-2526-000470
dated 10/09/2025
Model Name : Gate Pass No & Date :
Vehicle / Goods received in good condition and to our satisfaction.
Customer's Signature For SHRINIWAS VEHICLES INDIA LLP
