Company Name: Address 1 Address 2

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Logo

IMPORTER/FIRST/SECOND STAGE DEALER TAX IN

Comp

A
A

LOGO

Range:
Division:
INVOICE NO :
Date & Time of Issue
Date & Time of Removal
Name & Address of Consignee

S.No

Description of Goods

Commissionerate:
Mode of Transport : By Road
Veh.No :
PO No :
ECC No :
Division:
Range:
Commissio

Qty

Rate

Tariff No.

Rate of
Duty

Excise Amount :
Cess Amount :
Hcess Amount:
AED Amount:
Invoice Total :

Name & Ad
Manufactur
/Importer

Name & Address of Supplier


ECC No
Commissionarate

Range
Division

ECC No :
Range

Invoice No

RG 23 D Page No

Entry No

Date
S.No

Division

Commissio
Description of Goods

B/E No
Inv.No
Date

Qty(M.Ton)

Trariff No

Rate of
Duty

Excise Amount :
Cess Amount :
Hcess Amount:
AED Amount:
Invoice Total :
TERMS OF SALE
1) Goods once sold will not be taken back or
exchanged
2)Seller is not
responsible for any loss or damaged of goods in transit
3)Buyer undertakes to submit prescribted ST declaration to sender on
damand.Disputes if any will be subject to seller court jurisdication

R TAX INVOICE CUM CHALLAN(Under Rule 11 of C.Ex.Rules-2002)

Company Name
Address 1
Address 2
C.E.Regn No:
RG 23 D

ECC Code:
Page No.

Register No:
TIN No:
CST No:

ommissionerate

Duty Per
Unit

Excise

Total Amount of
Cess
Hcess

AED

Value in Rs.
(In Figures)

Loading Charges
Transport Charges
Sub Total
Vat
Invoice Total

ame & Address of


anufacturer
mporter

CC No :
ange

Raichur Range

vision

Bellary Division

ommissionarate
Duty Per
Unit

Belgaum
Total Amount of
Excise

Cess

Hcess

AED

Value in Rs.
(In Figures)

Certified that the Particulars given above are true and correct and
the amount indicated
a)represent the price actually charged and
that there is no flow additional consideration directly or indirectly
from the buyer or
b)is provisional as additional consideration will be
received from the buyer on account of

For Company Name

Authorised Signatory

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