Branch Address :
                                                                                  THEWORLD'S
RAJ MOTORS (12884)
                                                                                FAVOURITE
NH-17,OPP:DR AMBEDKAR COLLEGE
Maharashtra [State Code :27]                                                 INDIAN
                                                             BAJAJ
                                                          RAJ MOTORS (12884)
                                                         NH-17,OPP:DR AMBEDKAR
                                                         COLLEGEMaharashtra [State Code :27]

                                                        Tax Invoice Insurance Copy - Spares
GSTIN:
27AIXPB6533C1Z8
 Invoice No.           INS128842000032                                                     Invoice Type      Credit
 Invoice Date         29-03-2021                                                            Payment Type    :
 Billed To             :BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD               Reference No     :
 Customer Name     ADNAN MEHBOOB MANDRE                                           Jobcard No.      RJC12884202001499
 Insurance GSTIN No:27AABCB5730G1ZX                                                    Jobcard Date     29-03-2021
 Mobile No.                                                                                        Whether Tax     No
                                                                                                       Payable on
 Delivery Address :   :NH-17,OPP:DR AMBEDKAR COLLEGEMaharashtra [State          reverse Charges
                             Code:27]
                        GE PLAZA,AIRPORT ROAD,YERWADA                                Repair Type      Accidental Repair
 Insurance Address
                                                                                                       KM Reading       6030
                                 Pune City East,411006                                          Registration No.
                                                                                                                         MH06CB7385
                                  ,Email
                                                                                                       Chassis No.        MD2B64BY8KWF12247
                                                                                                      Engine No.        DHYWKF09982
                                                                                                       Model Name      Pulsar 125 DTS-i
                                                                                                       Policy No.         :


                                                                                                                  [SGST|[SGST|
                                                                                                   TAXABLE   /UTG       CGST| CGS IGST
 S.No. PART CODE PART NAME/HSN CODEFRATEUNITS  RATIO   DISC                    ST                               IGST AMOUNT
                                                                                                   AMOUNT           UTG  (%)   T    %
                                                                                                                   (%)  ST
                           52DH2983-FUEL TANK
          INS Part       KHI EB BLK SUP SILVER   4553.9                                                        637        637.
                                                                       1    100:0:0     0        4553.91    14          14                         5,829.01
                           DKL P125/87141090/         11                                                          55          55
                           87141090
          INS Part      DK141028-O RING/                         100:0:0
     2                                                    5.25                           o           5.25     90.47     90.47                      6.19
                           40169320 / 40169320
                           PABJ121L-PETROL                                                                        28.5        28.5
    3   [INS Part       LOCK /87149990/          204            100:0:0      0            204   14          14                           261.12
                                                                                                                             6            6
                           87149990
                                                                                        TOTAL      4,763.16       666.        666.       0.00  6,096.32
                                                                                                                             58         58
                                                                                                Round Off
                                                                                                                                                               6,420.82
                                                                                                Total Amount

  AMOUNT IN WORDS  RS SIX THOUSAND FOUR HUNDRED TWENTY AND PAISE EIGHTY TWO ONLY.
  Tax amount payable on reverse charges (in Rs.): NIL
  Customer Advice:


   Terms And Conditions :

                                                                                                                                            MO

                                                                                                                                     R                  S
                                                                                                                                      *

                                                    Get your vehicle serviced at regular intervels.
                                                  Next due date for service is      29-06-2021                 RAJ MOTORS (12884)
     Sign of Customer Or His Agent                             Thank You & Happy Riding                        Authorised Signatory

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