ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

IRN : af05f83bc1dfb06236cdbad6475582a210273f1c2f8136ef9c0e4737717f3371

Customer Name & Address : ID : 04-276 Invoice No. : 4/BI/23000284 Date : 21/05/2023 14:27:16
The New India Assurance Co Ltd
SHAHJAHANPUR BRANCH, Getuka Lodge Govindganj, Job Card No. : JC23001525 Job Card Date: 06/05/2023
SHAHJAHANPUR
Reg.No. : UP27BT2389 Mileage : 66444
Pin:242001
State & Code : 09-UTTAR PRADESH SA Name : GYANVEER SINGH SA(M) : 6386273807
Mobile : Model : MARUTI ERTIGA ZXI (O) CN EW Type : III
Loyalty Card : NA Fuel Trim : Chassis No. : 513370 Last Service : 53344 (11-03-23)
Next Service Due : PMS 50
Cust GSTIN/UIN : 09AAACN4165C4ZM PAN : AAACN4165C Service type: BODY REPAIR
Ins.Comp. : NIA
Place of Supply: UTTAR PRADESH
Surveyor Name :

Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour
Amount Amount Charges
Parts
Demanded Repairs-Others/Suggested Jobs
1 71711M72R00-5PK BUMPER,FRONT AE 87081090 28% 1.000 2042.96 2042.96 0.00
2 71721M73R00-5PK GRILLE,RADIATOR LOWER AE 87089900 28% 1.000 195.31 195.31 0.00
3 71740M50UB0-DB8 GRILLE,RADIATOR UPPER AA 87089900 28% 1.000 4261.71 4261.71 0.00
4 71761M73R10-5PK BEZEL,FRONT FOG LAMP,L AB 87082900 28% 1.000 82.03 82.03 0.00
5 71762M73R00-5PK COVER,FRONT FOG LAMP BEZEL,L AB 87082900 28% 1.000 55.46 55.46 0.00
6 72433M73R00 COVER,FRONT END LOWER AC 87089900 28% 1.000 210.93 210.93 0.00
7 72460M72R00 ABSORBER COMP,FR BUMPER AE 87089900 28% 1.000 265.62 265.62 0.00
LOWER
8 95310M72R00 CONDENSER ASSY AE 84159000 28% 1.000 2972.65 2972.65 0.00
9 990J0M999H2-060 BODY G3 ADVANCE LIQUID NAX PRO AA 34054000 18% 0.100 1461.01 146.10 0.00
10 990J0M999H2-130 BDY G.MOP MICROFBR FINSH CLTH 4 AA 63079090 5% 1.000 487.61 487.61 0.00
PCK
11 990J0M999H2-150 BDY WTRPROF SHEET - P1000 PCK AA 68052010 18% 0.100 3094.06 309.41 0.00
OF 50
12 990J0M999H2-970 WAX TOP KIT 100ML AA 34053000 18% 1.000 295.76 295.76 0.00
13 990J0M999H4-050 AC CAN GAS (450GM) SRF AF 29034500 18% 2.000 516.94 1033.88 0.00
Labour
 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

Customer Name & Address : ID : 04-276 Invoice No. : 4/BI/23000284 Date : 21/05/2023 14:27:16
The New India Assurance Co Ltd
SHAHJAHANPUR BRANCH, Getuka Lodge Govindganj, Job Card No. : JC23001525 Job Card Date: 06/05/2023
SHAHJAHANPUR
Reg.No. : UP27BT2389 Mileage : 66444
Pin:242001
State & Code : 09-UTTAR PRADESH SA Name : GYANVEER SINGH SA(M) : 6386273807
Mobile : Model : MARUTI ERTIGA ZXI (O) CN EW Type : III
Loyalty Card : NA Fuel Trim : Chassis No. : 513370 Last Service : 53344 (11-03-23)
Next Service Due : PMS 50
Cust GSTIN/UIN : 09AAACN4165C4ZM PAN : AAACN4165C Service type: BODY REPAIR
Ins.Comp. : NIA
Place of Supply: UTTAR PRADESH
Surveyor Name :

Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour
Amount Amount Charges
Labour
Demanded Repairs-Others/Suggested Jobs
1 ZF9992 DENTING CHARGES 998729 750.00
2 ZA28L0 AC GAS TOP-UP 998729 1,250.00
3 ZF27P0 FRONT BUMPER PAINTING 998729 4,531.00

Sub Total Amount : 12,359.43 0.00 6,531.00

MI-NIA, MR. SUBHAM GUPTA (MUSHAID)
CGST @ 14% : 1,412.12
SGST @ 14% : 1,412.12
CGST @ 9% : 160.67 587.79
SGST @ 9% : 160.67 587.79
For SUMITRA DS MOTORS PVT. LTD. CGST @ 2.5% : 12.19
SGST @ 2.5% : 12.19
Authorised Signatory Tax Collection at Source : 15.51
Dealer GSTIN : 09AAICS2580E1Z9
Sub Total Amount : 15,544.90 0.00 7,706.58
Net Bill Amount (Rounded) : 23,251.00
Rupees Twenty Three Thousand Two Hundred And Fifty One Only
** This is a system generated soft copy of invoice for insurance company records.

I acknowledge that the jobs/repairs/service carried out in my vehicle and the respective cost estimates were
explained to me. I have received my vehicle after completion of all repairs being carried out to my satisfaction and
I confirm that my vehicle is in good condition. I further authorize this workshop to contact me by call or sms to Customer Signature
inform me with any other information in relation to my vehicle.
Mobile No.:

Gate Pass
GP No. : GP23002233 Date : 21-MAY-23 14:28:38 Job Card No. Bill.No. Bill Date Amount
Cust. Name : The New India Assurance Co Ltd Model : NEW ERTIGA PETROL JC23001525 BI/23000284 21-MAY-23 23,251.00
Tech. Name : SACHIN SHUKLA Reg.No. : UP27BT2389

Customer Signature Accountant Signature

Created By: SHIV KUMAR SAGAR