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Form Vat 402 Way Bill

This document is a waybill issued electronically on August 12, 2014 at 4:00 PM. It details the transport of 1,280 bags of tobacco valued at Rs. 1,280,023 from M/s. Patel Dhirubhai & Co in Koyali, Baroda, Gujarat to M/s Patel Dhirubhai Co in Karamtoli, Sambalpur, Odisha. The goods are being transported by lorry with vehicle registration number GJ9V4582, owned and operated by A.B. Saiad Data Road Lines of Borshad, Gujarat. The waybill was issued and approved by the Sambalpur

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91 views1 page

Form Vat 402 Way Bill

This document is a waybill issued electronically on August 12, 2014 at 4:00 PM. It details the transport of 1,280 bags of tobacco valued at Rs. 1,280,023 from M/s. Patel Dhirubhai & Co in Koyali, Baroda, Gujarat to M/s Patel Dhirubhai Co in Karamtoli, Sambalpur, Odisha. The goods are being transported by lorry with vehicle registration number GJ9V4582, owned and operated by A.B. Saiad Data Road Lines of Borshad, Gujarat. The waybill was issued and approved by the Sambalpur

Uploaded by

Sanket0414
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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FORM VAT 402

WAY BILL
[See sub-rule (3) of rule 79]
Electronic
Confirmed and Printed On: 12/08/2014 16:02:00
Gujarat
Dealer of Odisha
(To whom waybill is issued
Name:
TIN:
Name:
Address:
TIN:
Place of Despatch of goods
1.
2.
3. 4. State of Despatch of goods 5. Date of Despatch of goods
(Actual/Expected Date)
6. Name of entry/exit check gate:
Consignee of goods
Name:
Address:
TIN:
7.
CST No:
8.
Delivery to the
buyer
After purchase
by self/by agent
Branch
transfer
Consignment
sale
Execution of
works contract
Transfer of
right to use
Consigner despatching goods for [(Tick) Mark in the appropriate box]
21351703611
M/s. Patel Dhirubhai & Co
PATEL DHIRUBHAI & CO.
KOYALI BARODA GUJARAT
KOYALI
12/8/2014
M/s Patel Dhirubhai Co
KARAMTOLI SAMBALPUR Budharaja
21351703611 21351703611
9.
Sl.N
o
Commodity & Code Invoice / Challan (in case of
sale / Purchase) / Other
document (other than sale /
purchase)
Quantity Value (in Rs)
Lahurachatti
Yes
W
A
Y

B
I
L
L

N
o
:
2
1
W
-
1
4
1
5
7
5
4
8
4
7
0
Any Other
reason,(plea
se specify)
Details of Invoice / Challan / Other document(s)
Sl. Number Date
Consignor of goods
W
A
Y

B
I
L
L

N
o
:
2
1
W
-
1
4
1
5
7
5
4
8
4
7
0
Tobacco-240110 12/8/2014 01/14-15 1,280,023.00 1
Bags
277.0000
Driver's Name Vehicle / Carrier Detail - Vehicle Regd.
No.
Lorry / Transport / Railway
Receipt No.
GJ9V4582
SARFARAJ
248
10.
Owner of Vehicle Transporter's Name and Address
A.B.SAIAD DATA ROAD LINES, BORSHAD, GUJARAT
Way bill issuing/approving Office 12. Way bill issuing/approving authority (Name &
Desgination)
11.
Sambalpur-I Circle
System Generated Waybill
Declaration of the Dealer of Orissa to whom Way bill issued
Seal
Date of Approval:
13.
I hereby indemnify the Government / Department / Officer (s) concerned
from any liabilities arising out of the use / misuse of this system generated
electronic Waybill.
21351703611
12/8/2014/ 4:00:38PM

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