Tax Invoice/Bill of Supply/Cash Memo

(Original for Recipient)

Sold By : Billing Address :

HCSR Retail Private Limited Mohd Rafi
*Babosa Industrial Park, Building No. A—4, Gala 401 cosmos residecy, Phase 1 sector 2 plot no 75
No. 10, Sa, ravali Bhiwandi Road No. Nasik NAVI MUMBAI, MAHARASHTRA, 410208
Highway IN
Thane, Maharashtra, 421302 State/UT Code:27
IN

Shipping Address :
PAN No:AAGCH5369E Mohd Rafi
GST Registration No:27AAGCH5369E1ZF Mohd Rafi
Dynamic QR Code: 401 cosmos residecy, Phase 1 sector 2 plot no 75
NAVI MUMBAI, MAHARASHTRA, 410208
IN
State/UT Code:27
Place of supply:MAHARASHTRA
Place of delivery:MAHARASHTRA
Order Number:407-5897698-3677962 Invoice Number :XIED-1478
Order Date:19.01.2025 Invoice Details :MH-XIED-198374203-2425
Invoice Date :19.01.2025

Sl. Unit Net Tax Tax Tax Total

Description Discount Qty
No Price Amount Rate Type Amount Amount
1 Everactiv by HCAH Lightweight Aluminium/Glossy
Finish Walker for adults, Height Adjustable Walking
Support for Old People, Sturdy Frame Walker for Old
People | Made in India | B0DH56FYMV (
₹1,846.66 ₹0.00 1 ₹1,846.66 2.5% CGST ₹46.17 ₹1,939.00
SEN245-EWCF-SFX )
HSN:87139010
2.5% SGST ₹46.17
Shipping Charges ₹38.10 -₹38.10 ₹0.00 2.5% CGST ₹0.00 ₹0.00
2.5% SGST ₹0.00
TOTAL: ₹92.34 ₹1,939.00
Amount in Words:
One Thousand Nine Hundred Thirty-nine only
For HCSR Retail Private Limited:

Authorized Signatory
Whether tax is payable under reverse charge - No

*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)

Customers desirous of availing input GST credit are requested to create a Business account and purchase on Amazon.in/business from Business eligible offers

Please note that this invoice is not a demand for payment

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 Tax Invoice/Bill of Supply/Cash Memo
(Original for Recipient)

Signature valid
Digitally signed by DS AMAZON SELLER SERVICES PRIVATE LIMITED 6

Date: 2025.01.19 18:15:21 UTC

Reason: Invoice
Sold By : Billing Address :
Amazon Seller Services Private Limited Mohd Rafi
*#26/1, Brigade Gateway, 8th Floor., Dr Mohd Rafi
Rajkumar Road, Malleshwaram West 401 cosmos residecy, Phase 1 sector 2 plot no 75
Bangalore, Karnataka – 560055 NAVI MUMBAI, MAHARASHTRA, 410208
IN IN
State/UT Code:27

PAN No:AAICA3918J
GST Registration No:29AAICA3918J1ZE Shipping Address :
CIN No:U51900KA2010PTC053234 Place of supply:MAHARASHTRA
Dynamic QR Code:

Order Number:407-5897698-3677962 Invoice Number :XIED-84

Order Date:19.01.2025 Invoice Details :MH-XIED-1044-2425
Invoice Date :19.01.2025

Sl. No Description Unit Price Qty Net Amount Tax Rate Tax Type Tax Amount Total Amount
1 Cash/Pay on Delivery fee: ₹8.47 ₹8.47 18% IGST ₹1.53 ₹10.00
TOTAL: ₹1.53 ₹10.00
Amount in Words:
Ten only
For Amazon Seller Services Private Limited:

Authorized Signatory
(1) Service Accounting Code: 998599

Whether tax is payable under reverse charge - No

Please note that this invoice is not a demand for payment

Regd Office: Amazon Seller Services Private Limited

8th Floor, Brigade World Trade Center
Dr Raj Kumar Road, Malleshwaram(West)

Telephone: +91 89 33420300

Fax: +91 80 30625685
Email: [email protected]
Amazon.in - Amazon Seller Services Private Limited

*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)

Customers desirous of availing input GST credit are requested to create a Business account and purchase on Amazon.in/business from Business eligible offers
Page 1 of 1