Tax Invoice
Original for recipient O
Duplicate for supplier O
Triplicate for transporter O
HERBALIFE INTERNATIONAL INDIA, PVT. LTD. Order No: 3I75366629
C/O FIT 3PL WAREHOUSING PRIVATE LIMITED Page: 1 of 1
BUILDING # VII/276-B, ADIMAKUTTY LINE, MALIKAMPEEDIKA, ALANGAD P.O.
Order Date: 13 MAY 2025
ERNAKULAM-683511,KERALA
GSTIN: 32AAACH8025R2ZB Order Month: MAY
Factura: TQ0015816
PAN: AAACH8025R Warehouse: TQ
Invoice No: KLI0001182914
FSSAI License No 10013043000639 Order Type: RSO
Reverse Charge: No Invoice Date: 13 MAY 2025
Order Channel: POS
Purchased By : Ship To :
ID # : W1C5223981 Name : Prasanth Vijay
Name : PRASANTH VIJAY
Address : Prasanth Vijay
GSTIN :
PAN : Krishnamandiram
Govt press post, Alin chuvadu
Sponsor : JISHA C (W1C2439256)
PALAKKAD,KERALA 679122
Address : KRISHNA MANDIRAM
ALIN CHUVAD,SHORNUR,SG PRESS
SHORANUR-I,KERALA 679122
Place of Supply: KERALA State: KERALA
State Code: 32 State Code: 32
SL. SKU Description MRP Per Qty Retail Price Total Discount Taxable SGST CGST
No. Unit [Units] Per Unit Value Rate Amount Rate Amount
1 1233 PERSONALIZED PROTEIN POWDER-200G 1455.00 1 1233.00 1233.00 269.75 963.25 9 86.69 9 86.69
HSN/SAC 21061000
2 154K FORMULA 1 ROSE KHEER HSN/SAC 2449.00 1 2075.00 2075.00 454.25 1620.75 9 145.87 9 145.86
21069099
3 183K SHAKE MATE HSN/SAC 21069099 733.00 3 621.00 1863.00 229.50 1633.50 9 147.02 9 147.01
4 230K AFRESH ENERGY DRINK MIX - KASHMIRI 913.00 1 773.00 773.00 169.25 603.75 9 54.34 9 54.33
KAHWA HSN/SAC 21069099
5 287K FORMULA 1 NUTRITIONAL SHAKE MIX – 2449.00 1 2075.00 2075.00 454.25 1620.75 9 145.87 9 145.86
PAAN HSN/SAC 21069099
6 4114 FORMULA 1 NUTRITIONAL SHAKE MIX- 2449.00 1 2075.00 2075.00 454.25 1620.75 9 145.87 9 145.86
KULFI HSN/SAC 21069099
Delivery Charges SAC - 999799 0.00 0.00 0.00
Total 10094.00 2031.25 8062.75 725.66 725.61
Invoice Value (in words) Invoice Total: 9514.02
Nine thousand five hundred fourteen (Rounded off) Net Savings: 2399.98 [Total MRP (-) Order Total (excluding DC)]
SHIPPING INSTRUCTIONS/ EWAY BILL NO
LSP :
INVOICE WITH SHIPMENT Volume Points: 103.9
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" Digitally Signed By
"The above products have been shipped. Remaining Products, if any from the Order, will be
shipped within 30 days from the receipt of the Order." ARNAB CHAKRABORTY
Date:
Date: 13-May-2025 11:25:45 IST
Regd.Office: P C Complex No.46/B-47, 1st Main Road, 3rd Phase, J.P.Nagar, Bengaluru – 560 078, 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
HERBALIFE INTERNATIONAL INDIA, PVT. LTD.
Order No : 3I75366629
C/O FIT 3PL WAREHOUSING PRIVATE LIMITED Factura : TQ0015816
BUILDING # VII/276-B, ADIMAKUTTY LINE, MALIKAMPEEDIKA, ALANGAD P.O.
ERNAKULAM-683511,KERALA
GSTIN: 32AAACH8025R2ZB
SL. BARCODE
SKU DESCRIPTION
NO.
1 1233 PERSONALIZED PROTEIN POWDER-200G HSN/SAC 21061000 U1233002024048673489
2 154K FORMULA 1 ROSE KHEER HSN/SAC 21069099 U154K002024007066178
3 183K SHAKE MATE HSN/SAC 21069099 U183K002024039791724
4 183K SHAKE MATE HSN/SAC 21069099 U183K002024039791727
5 183K SHAKE MATE HSN/SAC 21069099 U183K002024039791728
6 230K AFRESH ENERGY DRINK MIX - KASHMIRI KAHWA HSN/SAC U230KIN0120242001659
21069099
7 287K FORMULA 1 NUTRITIONAL SHAKE MIX – PAAN HSN/SAC U287K002024001483756
21069099
8 4114 FORMULA 1 NUTRITIONAL SHAKE MIX-KULFI HSN/SAC 21069099 U4114002024025863132
