Tax Invoice

Original for recipient O

Duplicate for supplier O
Triplicate for transporter O
HERBALIFE INTERNATIONAL INDIA, PVT. LTD. Order No: W5G8939759
Shop no -160,161,162, Page: 1 of 2
Ground floor,DLF South court, Saket,
Order Date: 25 SEP 2023
NEW DELHI-110017,DELHI
GSTIN: 07AAACH8025R1Z5 Order Month: SEP
Factura: W50015564
PAN: AAACH8025R Warehouse: W5
Invoice No: DLI0001004734
FSSAI License No 10013043000639 Order Type: RSO
Reverse Charge: No Invoice Date: 25 SEP 2023
Order Channel: Walk In

Purchased By : Ship To :
ID # : W1C3258412 Name : BAL KISHAN
Name : BAL KISHAN
Address : PU BY PB / Delivery Ends at
GSTIN :
PAN : NEW DELHI,DELHI 110017
Sponsor : MAITHUR MISTRI (W1C2645044)
Address : GALI NO. 8, NEAR SUN SHINE
SCHOOL HANUMAN NAGAR
FARIDABAD,HARYANA 121002

Place of Supply: DELHI State: DELHI

State Code: 07 State Code: 7

SL. SKU Description MRP Per Qty Retail Price Total Discount Taxable SGST CGST
No. Unit [Units] Per Unit Value
Rate Amount Rate Amount

1 0065 HERBALIFELINE HSN/SAC 2785.00 1 2360.00 2360.00 510.50 1849.50 9 166.46 9 166.45
21069099

2 0111 CELL-U-LOSS HSN/SAC 1780.00 1 1508.00 1508.00 326.25 1181.75 9 106.36 9 106.35
21069099

3 1232 FORMULA 2 MULTIVITAMIN 2091.00 1 1772.00 1772.00 383.25 1388.75 9 124.99 9 124.98
MINERAL & HERBAL TABLETS
HSN/SAC 21069099

4 1569 PERSONALIZED PROTEIN 2594.00 1 2198.00 2198.00 475.50 1722.50 9 155.03 9 155.02
POWDER-400G HSN/SAC
21061000

5 183K SHAKE MATE HSN/SAC 681.00 1 577.00 577.00 71.00 506.00 9 45.54 9 45.54
21069099

6 4114 FORMULA 1 NUTRITIONAL 2276.00 1 1928.00 1928.00 417.00 1511.00 9 135.99 9 135.99
SHAKE MIX-KULFI HSN/SAC
21069099

Delivery Charges SAC - 999799 0.00 0.00 0.00

Total 10343.00 2183.50 8159.50 734.37 734.33
Invoice Value (in words) Invoice Total: 9628.20
Nine thousand six hundred twenty-eight (Rounded off) Net Savings: 2578.80 [Total MRP (-) Order Total (excluding DC)]
SHIPPING INSTRUCTIONS/ EWAY BILL NO
LSP : Blue Dart
Thank you for your order

Volume Points: 112.15

Guarantee: Name of Authorised Signatory

"We hereby certify that food/ foods mentioned in this invoice is/ are warranted
to be of the nature and quality which it/ these purports/ purported to be"
Date:

Regd.Office: RMZ Pinnacle, No. 15, Commissariat Road Bangalore – 560 025, Karnataka, India. CIN: U51909KA1998PTC026098.
Authorised Signatory
Toll Free:1800 102 2444 Fax:080-40311445 Email Id:preferredcustomer@herbalife.com Website:www.myherbalife.com/en-in/ For Herbalife International India Pvt. Ltd.
 Tax Invoice
Original for recipient O
Duplicate for supplier O
Triplicate for transporter O
HERBALIFE INTERNATIONAL INDIA, PVT. LTD. Order No: W5G8939759
Shop no -160,161,162, Page: 2 of 2
Ground floor,DLF South court, Saket,
Order Date: 25 SEP 2023
NEW DELHI-110017,DELHI
GSTIN: 07AAACH8025R1Z5 Order Month: SEP
Factura: W50015564
PAN: AAACH8025R Warehouse: W5
Invoice No: DLI0001004734
FSSAI License No 10013043000639 Order Type: RSO
Reverse Charge: No Invoice Date: 25 SEP 2023
Order Channel: Walk In

Purchased By : Ship To :
ID # : W1C3258412 Name : BAL KISHAN
Name : BAL KISHAN
Address : PU BY PB / Delivery Ends at
GSTIN :
PAN : NEW DELHI,DELHI 110017
Sponsor : MAITHUR MISTRI (W1C2645044)
Address : GALI NO. 8, NEAR SUN SHINE
SCHOOL HANUMAN NAGAR
FARIDABAD,HARYANA 121002

Place of Supply: DELHI State: DELHI

State Code: 07 State Code: 7

SL. SKU Description MRP Per Qty Retail Price Total Discount Taxable SGST CGST
No. Unit [Units] Per Unit Value
Rate Amount Rate Amount

7 540S PRODUCT CATALOGUE FOR 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00
PREFERRED CUSTOMER HSN/
SAC 49111090

8 833S HN POWER BOOST SHAKER 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00
HSN/SAC 39249090

Delivery Charges SAC - 999799 0.00 0.00 0.00

Total 10343.00 2183.50 8159.50 734.37 734.33
Invoice Value (in words) Invoice Total: 9628.20
Nine thousand six hundred twenty-eight (Rounded off) Net Savings: 2578.80 [Total MRP (-) Order Total (excluding DC)]
SHIPPING INSTRUCTIONS/ EWAY BILL NO
LSP : Blue Dart
Thank you for your order

Volume Points: 112.15

Guarantee: Name of Authorised Signatory

"We hereby certify that food/ foods mentioned in this invoice is/ are warranted
to be of the nature and quality which it/ these purports/ purported to be"
Date:

Regd.Office: RMZ Pinnacle, No. 15, Commissariat Road Bangalore – 560 025, Karnataka, India. CIN: U51909KA1998PTC026098.
Authorised Signatory
Toll Free:1800 102 2444 Fax:080-40311445 Email Id:preferredcustomer@herbalife.com Website:www.myherbalife.com/en-in/ For Herbalife International India Pvt. Ltd.
 Annexure

Order No : W5G8939759
HERBALIFE INTERNATIONAL INDIA, PVT. LTD.
Shop no -160,161,162, Factura : W50015564
Ground floor,DLF South court, Saket,
NEW DELHI-110017,DELHI
GSTIN: 07AAACH8025R1Z5

SL. BARCODE
SKU DESCRIPTION
NO.

1 0065 HERBALIFELINE HSN/SAC 21069099 U0065IN0020232014188

2 0111 CELL-U-LOSS HSN/SAC 21069099 U0111IN0020238233279

3 1232 FORMULA 2 MULTIVITAMIN MINERAL & HERBAL TABLETS HSN/SAC U1232IN0020238477155

21069099

4 1569 PERSONALIZED PROTEIN POWDER-400G HSN/SAC 21061000 U1569002023014974656

5 183K SHAKE MATE HSN/SAC 21069099 U183K002023019730039

6 4114 FORMULA 1 NUTRITIONAL SHAKE MIX-KULFI HSN/SAC 21069099 U4114002023017367317

7 540S PRODUCT CATALOGUE FOR PREFERRED CUSTOMER HSN/SAC 49111090

8 833S HN POWER BOOST SHAKER HSN/SAC 39249090