TAX INVOICE S.L.A No. 74243/15-20 Exp. Date - 09-FEB-2020 Pan No.AILPG1759P Ph.-Mobile - 9549654777 Er. PREM NARAYAN GUPTA Surveyor and loss Assessor G-39 YASH TOWER BAJAJ ROAD SIKAR F-1, 180, Ganesh Nagar Niwaru Road Jhotwara, Jaipur-302012 (Rajasthan), Mobile : 9549654777 surveyorpngupta@gmail.com Details of Receiver (Billed to) Name Bajaj Allianz Insurance Co. Ltd Invoice NO. PN202005111 Address Jaipur Date of Invoice 18-11-20 State Rajasthan Vehicle No. RJ10SJ7923 State Code 08 Insured Name MR. ASHOK KUMAR Place of Supply Jaipur Rajasthan Date of accident 08-Oct-20 GSTIN/Unique ID 08AABCB5730G1ZX Policy No. OG-21-9906-1802-00088121 Claim No. OC-21-1401-1802-00000702 s No Particulars Amount 0.00 1 Spot Professional Fee : 0.00 Photos/ CD Expenses : 0.00 0 Conveyance Expenses : 0.00 2450.00 2 Final Professional Fee : 750.00 Photos/ CD Expenses : 50.00 Conveyance Expenses : 7.5X220 SIKAR TO RAJGARH 1650.00 VISIT 2 0.00 3 Reinspection Professional Fee : 0.00 Photos/ CD Expenses : 0.00 Conveyance Expenses : 0.00 Taxable value 2450.00 CGST @ 9% 220.50 SGST @ 9% 220.50 Total Invoice Value (In figure) 2891 Total Invoice Value (In Words) Rs. Two Thousand Eight Hundred Ninety One Only GSTIN/Unique ID- 08AILPG1759P1ZM SAC Code 440169 Bank Name : AXIS BANK LTD A/C No. : 913010019547059 MICR No. : 302211002 PREM NARAYAN GUPTA ---PAGE END---