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. PN202009412 Address Jaipur Date of Invoice 30-12-20 State Rajasthan Vehicle No. RJ34UA0230 State Code 08 Insured Name Mr SAKIL KHAN Place of Supply Jaipur Rajasthan Date of accident 09-Nov-20 GSTIN/Unique ID 08AABCB5730G1ZX Policy No. OG-20-1401-1801-00015306 Claim No. OC-21-1401-1801-00003365 s No Particulars Amount 0.00 1 Spot Professional Fee : 0.00 Photos/ CD Expenses : 0.00 0 Conveyance Expenses : 0.00 2750.00 2 Final Professional Fee : 1500.00 Photos/ CD Expenses : 50.00 Conveyance Expenses : 7.5X160 SIKAR TO SUJANGARH 1200.00 VISIT 2 0.00 3 Reinspection Professional Fee : 0.00 Photos/ CD Expenses : 0.00 Conveyance Expenses : 0.00 Taxable value 2750.00 CGST @ 9% 247.50 SGST @ 9% 247.50 Total Invoice Value (In figure) 3245 Total Invoice Value (In Words) Rs. Three Thousand Two Hundred Forty Five 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---