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Annexure- I

Declaration for Sale invoices in electronic media Refund on the


Bill of Entry No. 786833 dt-28/03/2011,
Bill of Entry No. 3164149 dt-08/04/2011,
Bill of Entry No. 3399069 dt-04/05/2011,
Bill of Entry No. 3419209 dt-05/05/2011,
Bill of Entry No. 3556605 dt-20/05/2011,
Bill of Entry No. 3778548 dt-13/06/2011.

We M/s Vigen Healthy Tech India Pvt. Ltd., the importers, declare and certify that the
exemption from Additional duty and consequent refund, as contained in the Notification No.
102/2007 dated 14-09-2007, is being claimed and is required to be given effect because the
conditions as are stipulated therein are fulfilled in respect of the Bill of Entry No. 786833 dt-28/03/2011,
Bill of Entry No. 3164149 dt-08/04/2011,
Bill of Entry No. 3399069 dt-04/05/2011,
Bill of Entry No. 3419209 dt-05/05/2011,
Bill of Entry No. 3556605 dt-20/05/2011,
Bill of Entry No. 3778548 dt-13/06/2011. :a)

We are registered with VAT authorities of the state ofDelhi under Registration No. TIN No. 07520362966, and
Maharashtra under Registration No. TIN No. 27510820821.

b)

For the purpose of fulfillment of the conditions of the Notification No. 102/2007Customs dated 14.9.2007, we are submitting copy of invoices in electronic form
(including the form of CD).

It is further certified that


1.

The electronic media is containing the information about sale invoices and is submitted
along with this paper declaration indicating the invoice numbers contained in the media.

2.

The above information is true extract from the sale invoices and Carbon copy / Office
copy in original of the said invoices and the original shall be submitted, if so required.

Place:
Date: ____
For M/s Vigen Healthy Tech India Pvt. Ltd.
Authorised Signatory

Summary of the details in the media correlating the payment of ST/VAT on the imported goods
(in respect of which refund is claimed) with the invoices of sale.

Note The details of local sales invoices pertaining to each Bill of entry have been separately represented one after
another.

Every such representation (BE) is numbered separately and serially, with respective Bill of Entry number at top
and each BE related details begins from 1.
In S. No. 2 (Bill of Entry No -3164149 dt-08/04/2011), Two different items have imported, and details of
invoices of each item have been represented separately after finishing first one.
Totals of quantity of Sales and amount of sale value in Rs. for each item as imported under distinct Bill of entry
are detailed separately and the respective VAT & CST paid are show underneath for brevity.
Decimal Digits have been removed from totals.
.
S.no.

Bill of entry
&
Date

Bill of Entry No 786833 dt28/03/2011

Bill of Entry No 3164149 dt08/04/2011

Challan
&
Date

Item
description

TR-6 Challan
2000969625
dt25/04/2011
TR-6 Challan
2001054279
dt04/05/2011

VG-9500-Top &
Top

70 unit

141616.00

Total
items
on
which
SAD
refund
is
claime
d
63

VTB-2000

1034

737471.00

283

201841.00

VHB-19W

2200

48612.00

00

00

250

60765.00

162

4474.00

HEXAGON- BALL

200
(packet)

23705.00

00

00

SUPER HYGIEA

3 packet

1175.00

00

00

60 unit

120083.00

00

00

990 unit

131431.00

141

35821.00

416874.00

29243.40

8337748.00

878885.80

9955520.00

538842.50

5724424.00

127555.10

VHB-102-C.Belt

Bill of Entry No
3399069 dt04/05/2011

Bill of Entry No 3419209 dt05/05/2011

Total
quantity
of import
on which
SAD is
paid

Total SAD
paid

Sad refund
claimed

Total sales
amount

Sales tax
paid

127454.00

4652987.00

146357.50

8262375.04

919226.80

1946912.00

167180.90

TR-6 Challan
2001094075
dt09/05/2011

VG-9500-Top &
Top

TR-6 Challan
2001223148
dt
31/05/2011

VG-8000- Top &


Top

132

158129.00

132

158129.00

HUMONY SLIM

70

103523.00

00

00

HUMONY FOOT
BOARD

70

15451.00

00

00

CSMETIC SET

1.40 kg

1084.00

00

00

HOT GEL

0.17 kg

847.00

00

00

FUNCTIONAL
GEL

0.30 kg

452.00

00

00

9 BALL PROJ.

1010

136953.00

00

00

VTDP-1000
VG-8000- Top &
Top
CABLE 4 PIN

63
160

21356.00
193766.00

00
160

00
193766.00

70

884.00

00

00

ARM PAD
VG-8000- Top &
Top

70
90

5788.00
109444.00

00
90

00
109444.00

Bill of Entry No
3556605 dt20/05/2011

TR-6 Challan
2001176397
dt31/05/2011

Bill of Entry No
3778548 dt13/06/2011

TR-6 Challan
2001346441
dt20/06/2011

9 BALL PROJ.

S.no.

Bill of entry
&
Date

Challan
&
Date

Bill of Entry No
-786833 dt28/03/2011

local sales
Invoice no.

S.No.

Item
description

TR-6 Challan
2000969625 dt25/04/2011

Total
quantity of
import
on which
SAD is paid

VG-9500-Top &
Top

Vch Type
LST
CST

Total SAD
paid

70 unit

141616

Total
items
on
which
SAD
refund
is
claime
d
63

Sad
refund
claime
d

127454

1
1

Amount of sale
in Rs.
70045
70045

VAT/CST
8755.625
1400.9

Place
MUMBAI
MUMBAI

1
2

47
49

Date
25-4-2011
25-4-2011

Quantity

50

25-4-2011

CST

70045

1400.9

MUMBAI

51

25-4-2011

CST

70045

1400.9

MUMBAI

52

25-4-2011

CST

280180

5603.6

MUMBAI

53

25-4-2011

CST

140090

2801.8

MUMBAI

54

25-4-2011

CST

280180

5603.6

MUMBAI

55

25-4-2011

CST

280180

5603.6

MUMBAI

56

27-4-2011

CST

280180

5603.6

MUMBAI

10

57

27-4-2011

CST

70045

1400.9

MUMBAI

11

58

27-4-2011

CST

140090

2801.8

MUMBAI

12

59

27-4-2011

LST

70045

8755.625

MUMBAI

13

60

30-4-2011

CST

140090

2801.8

MUMBAI

14

87

29-4-2011

CST

420270

8405.4

MUMBAI

15

88

12/5/2011

CST

280180

5603.6

MUMBAI

16

89

12-05.2011

CST

210135

4202.7

MUMBAI

17

106

12-05.2011

CST

91877

1837.54

MUMBAI

18

107

30-5-2011

CST

11

770495

15409.9

MUMBAI

19

111

30.05.11

CST

183754

3675.08

MUMBAI

20

136

2/6/2011

LST

91877

11484.63

MUMBAI

21

146

22-6-2011

LST

91877

11484.63

MUMBAI

22

163

1/7/2011

LST

91877

11484.63

MUMBAI

23

174

15-7-2011

LST

91877

11484.63

MUMBAI

24

196

15-7-2011

CST

91877

1837.54

DELHI

25

347

15-7-2011

CST

91877

1837.54

DELHI

26

384

09.09.2011

CST

91877

1837.54

DELHI

27

386

7.10.2011

CST

91877

1837.54

DELHI

63

4652987

146357.5

Total sales
amount

4652987.00

Sales tax
paid

146357.50

S.no.

Bill of entry
&
Date

Bill of Entry No 3164149 dt08/04/2011

Challan
&
Date

Item
description

Total
quantity
of import
on which
SAD is
paid

TR-6 Challan
2001054279
dt04/05/2011

VTB-2000

1034

VHB-19W

Sad refund
claimed

737471.00

Total
items
on
which
SAD
refund
is
claime
d
283

2200

48612.00

00

00

250

60765.00

162

4474.00

HEXAGON- BALL

200
(packet)

23705.00

00

00

SUPER HYGIEA

3 packet

1175.00

00

00

VHB-102-C.Belt

Total SAD
paid

201841.00

VTB-2000

S. No.

Sales
Invoice
No.

Date

63

05-09-2011

LST

25

751125

93890.63

Mumbai

74

05-09-2011

LST

180270

22533.75

Mumbai

75

05-09-2011

LST

120180

15022.5

Mumbai

76

05-09-2011

LST

150225

18778.13

Mumbai

79

13-5-2011

LST

210315

26289.38

Mumbai

94

18-5-2011

LST

150225

18778.13

Mumbai

96

23-5-2011

LST

90135

11266.88

Mumbai

100

23-5-2011

CST

150225

3004.5

Mumbai

10

101

23-5-2011

CST

14

420630

8412.6

Mumbai

11

102

23-5-2011

CST

210315

4206.3

Mumbai

12

104

28-5-2011

LST

30045

3755.625

Mumbai

13

108

06-02-2011

LST

10

300450

37556.25

Mumbai

14

118

06-07-2011

CST

90135

1802.7

Mumbai

15

115

06-09-2011

LST

120180

15022.5

Mumbai

16

125

15-6-2011

LST

210315

26289.38

Mumbai

17

134

21-6-2011

LST

60090

7511.25

Mumbai

18

137

24-6-2011

LST

120180

15022.5

Mumbai

19

139

27-6-2011

LST

60090

7511.25

Mumbai

20

140

27-6-2011

LST

120180

15022.5

Mumbai

21

142

28-6-2011

LST

150225

18778.13

Mumbai

22

143

28-6-2011

LST

11

330495

41311.88

Mumbai

23

144

28-6-2011

LST

11

330495

41311.88

Mumbai

24

145

28-6-2011

LST

11

330495

41311.88

Mumbai

25

147

07-01-2011

LST

30045

3755.625

Mumbai

26

150

07-05-2011

LST

150225

18778.13

Mumbai

27

153

07-08-2011

LST

30045

3755.625

Mumbai

28

154

07-08-2011

LST

10

300450

37556.25

Mumbai

Vch Type

Amount of sale
in Rs.

Quantity

VAT/CST

Place

Total sales
amount

Sales tax
paid

8262375.04

919226.80

1946912.00

167180.90

29

160

07-12-2011

LST

60090

7511.25

Mumbai

30

162

13-7-2011

LST

30045

3755.625

Mumbai

32

166

15-7-2011

LST

90135

11266.88

Mumbai

33

182

20-7-2011

LST

150225

18778.13

Mumbai

34

185

20-7-2011

LST

30045

3755.625

Mumbai

35

186

21-7-2011

LST

30045

3755.625

Mumbai

36

189

22-7-2011

LST

30045

3755.625

Mumbai

37

195

22-7-2011

LST

30045

3755.625

Mumbai

38

203

26-7-2011

LST

30045

3755.625

Mumbai

39

213

08-01-2011

LST

90135

11266.88

Mumbai

40

211

08-01-2011

LST

150225

18778.13

Mumbai

41

217

08-05-2011

LST

30045

3755.625

Mumbai

42

218

08-08-2011

LST

30045

3755.625

Mumbai

43

220

08-09-2011

LST

30045

3755.625

Mumbai

44

221

08-10-2011

LST

90135

11266.88

Mumbai

45

225

08-11-2011

LST

240360

30045

Mumbai

46

228

08-12-2011

LST

120180

15022.5

Mumbai

47

232

17-8-2011

LST

30045

3755.625

Mumbai

48

231

17-8-2011

LST

60090

7511.25

Mumbai

49

235

18-8-2011

LST

30045

3755.625

Mumbai

50

240

19-8-2011

LST

90135

11266.88

Mumbai

51

243

23-8-2011

LST

30045

3755.625

Mumbai

52

257

30-8-2011

LST

30045

3755.625

Mumbai

53

258

30-8-2011

LST

19

570855

71356.88

Mumbai

54

261

09-03-2011

LST

120180

15022.5

Mumbai

55

264

09-05-2011

LST

150225

18778.13

Mumbai

56

267

09-09-2011

LST

30045

3755.625

Mumbai

57

269

09-09-2011

LST

60090

7511.25

Mumbai

58

270

09-11-2011

LST

0.04

0.005

Mumbai

59

275

13-9-2011

LST

90135

11266.88

Mumbai

60

277

13-9-2011

CST

210315

4206.3

Mumbai

61

278

19-9-2011

LST

60090

7511.25

Mumbai

62

280

22-9-2011

LST

30045

3755.625

Mumbai

63

282

22-9-2011

LST

60090

7511.25

Mumbai

64

287

29-9-2011

LST

30045

3755.625

Mumbai

65

290

29-9-2011

LST

30045

3755.625

Mumbai

66

291

29-9-2011

LST

90135

11266.88

Mumbai

279

8262375.04

919226.8

Champion belt
S.No.

Vch No.

Date

Vch Type

Quantity

Value

Tax

Place

67

91

13-5-2011

CST

10667

213.34

MUMBAI

68

95

18-5-2011

CST

64002

1280.04

MUMBAI

69

107

28-5-2011

CST

11

117337

2346.74

MUMBAI

70

111

06-02-2011

CST

10667

213.34

MUMBAI

71

173

15-7-2011

LST

24320

3040

MUMBAI

72

172

15-7-2011

LST

48640

6080

MUMBAI

73

171

15-7-2011

LST

24320

3040

MUMBAI

74

164

15-7-2011

LST

48640

6080

MUMBAI

75

169

15-7-2011

LST

12160

1520

MUMBAI

76

179

19-7-2011

LST

12160

1520

MUMBAI

77

177

19-7-2011

LST

24320

3040

MUMBAI

78

176

19-7-2011

LST

36480

4560

MUMBAI

79

185

20-7-2011

LST

12160

1520

MUMBAI

80

194

22-7-2011

LST

12160

1520

MUMBAI

81

198

25-7-2011

LST

24320

3040

MUMBAI

82

208

08-02-2011

LST

12160

1520

MUMBAI

83

214

08-02-2011

LST

24320

3040

MUMBAI

84

226

08-12-2011

LST

12160

1520

MUMBAI

85

230

16-8-2011

LST

24320

3040

MUMBAI

86

234

17-8-2011

LST

48640

6080

MUMBAI

87

231

17-8-2011

LST

24320

3040

MUMBAI

88

238

18-8-2011

LST

48640

6080

MUMBAI

89

237

18-8-2011

LST

12160

1520

MUMBAI

90

236

18-8-2011

LST

60800

7600

MUMBAI

91

241

19-8-2011

LST

24320

3040

MUMBAI

92

239

19-8-2011

LST

12160

1520

MUMBAI

93

246

23-8-2011

LST

10

121600

15200

MUMBAI

94

243

23-8-2011

LST

12160

1520

MUMBAI

95

244

23-8-2011

LST

12160

1520

MUMBAI

96

250

24-8-2011

LST

36480

4560

MUMBAI

97

259

25-8-2011

LST

48640

6080

MUMBAI

98

252

25-8-2011

LST

12160

1520

MUMBAI

99

253

25-8-2011

LST

12160

1520

MUMBAI

100

260

25-8-2011

LST

12160

1520

MUMBAI

101

257

30-8-2011

LST

24320

3040

MUMBAI

102

265

09-05-2011

LST

48640

6080

MUMBAI

103

269

09-09-2011

LST

12160

1520

MUMBAI

104

271

09-11-2011

LST

12160

1520

MUMBAI

105

274

13-9-2011

LST

24320

3040

MUMBAI

106

276

13-9-2011

LST

24320

3040

MUMBAI

107

288

29-9-2011

LST

36480

4560

MUMBAI

108

289

29-9-2011

LST

12160

1520

MUMBAI

109

290

29-9-2011

LST

24320

3040

MUMBAI

110

292

29-9-2011

LST

12160

1520

MUMBAI

112

242

28-7-2011

CST

24320

486.4

DELHI

113

245

08-01-2011

CST

12160

243.2

DELHI

114

LST-11

08-03-2011

LST

114798.6

14349.83

DELHI

115

255

08-05-2011

CST

12160

1520

DELHI

116

261

08-09-2011

CST

48640

972.8

DELHI

117

278

17-8-2011

CST

36480

729.6

DELHI

118

286

19-8-2011

CST

24320

486.4

DELHI

119

289

22-8-2011

CST

48640

972.8

DELHI

120

290

23-8-2011

CST

36480

729.6

DELHI

121

299

24-8-2011

CST

12160

243.2

DELHI

122

300

24-8-2011

CST

24320

486.4

DELHI

123

301

25-8-2011

CST

24320

486.4

DELHI

124

LST-22

26-8-2011

LST

12160

1520

DELHI

125

307

29-8-2011

CST

24320

486.4

DELHI

126

308

29-8-2011

CST

12160

243.2

DELHI

127

310

30-8-2011

CST

24320

486.4

DELHI

128

318

09-02-2011

CST

85120

1702.4

DELHI

129

321

09-05-2011

CST

24320

486.4

DELHI

130

327

09-05-2011

CST

60800

1216

DELHI
DELHI

160

Total of
both
items of
instant
Bill of
entry

160 units
279 units

1946912

167180.9

1946912.00
8262375.04
10239287.04

167180.90
919226.80
1086407.70

S.no.

Bill of entry
&
Date

Bill of Entry No
3399069 dt04/05/2011

Challan
&
Date

Item
description

Total
quantity
of import
on which
SAD is
paid

TR-6 Challan
2001094075
dt09/05/2011

VG-9500-Top &
Top
9 BALL PROJ.

Vch Type

60 unit

120083.00

Total
items
on
which
SAD
refund
is
claime
d
00

990 unit

131431.00

141

Quantity

Total SAD
paid

Value

Sad refund
claimed

35821.00

Total sales
amount

Sales tax
paid

00

S.No.

Vch No.

Date

VAT/CST

75

05-09-2011

LST

12444

1555.5

MUMBAI

74

05-09-2011

LST

18666

2333.25

MUMBAI

76

05-09-2011

LST

15555

1944.375

MUMBAI

63

05-09-2011

LST

25

77775

9721.875

MUMBAI

79

13-5-2011

LST

21777

2722.125

MUMBAI

95

18-5-2011

CST

24888

497.76

MUMBAI

94

18-5-2011

LST

15555

1944.375

MUMBAI

97

18-5-2011

CST

27999

559.98

MUMBAI

10

102

23-5-2011

CST

21777

435.54

MUMBAI

11

101

23-5-2011

CST

14

43554

871.08

MUMBAI

12

100

23-5-2011

CST

9333

186.66

MUMBAI

13

106

30-5-2011

CST

27999

559.98

MUMBAI

15

108

06-02-2011

LST

10

31110

3888.75

MUMBAI

17

115

06-09-2011

LST

6222

777.75

MUMBAI

18

156

20.06.11

CST

17

52887

1057.74

DELHI

19

178

02.07.11

CST

9333

186.66

DELHI

134

416874

29243.4

416874.00

29243.40

S.no.

Bill of entry
&
Date

Bill of Entry No 3419209 dt05/05/2011

Challan
&
Date

Item
description

Sad refund
claimed

158129.00

Total
items
on
which
SAD
refund
is
claime
d
132

TR-6 Challan
2001223148
dt
31/05/2011

VG-8000- Top &


Top

132

HUMONY SLIM

70

103523.00

00

00

HUMONY FOOT
BOARD

70

15451.00

00

00

CSMETIC SET

1.40 kg

1084.00

00

00

HOT GEL

0.17 kg

847.00

00

00

FUNCTIONAL
GEL

0.30 kg

452.00

00

00

9 BALL PROJ.

1010

136953.00

00

00

63

21356.00

00

00

VTDP-1000

Total
quantity
of import
on which
SAD is
paid

Total SAD
paid

158129.00

VG-8000

S.No.

Vch No.

Date

109

02.06.11

LST

10

622220

77777.5

MUMBAI

110

02.06.11

LST

10

622220

77777.5

MUMBAI

113

06.06.11

LST

186666

23333.25

MUMBAI

114

09.06.11

LST

10

622220

77777.5

MUMBAI

120

13.6.2011

LST

186666

23333.25

MUMBAI

121

10.06.11

CST

311110

6222.2

MUMBAI

122

13.6.2011

LST

311110

38888.75

MUMBAI

123

15.6.2011

LST

124444

15555.5

MUMBAI

124

15.6.2011

LST

62,222.00

7777.75

MUMBAI

10

125

15.6.2011

LST

497776

62222

MUMBAI

11

127

15.6.2011

LST

435554

54444.25

MUMBAI

12

128

15.6.2011

LST

311110

38888.75

MUMBAI

13

129

15.6.2011

LST

10

622220

77777.5

MUMBAI

14

130

15.6.2011

LST

311110

38888.75

MUMBAI

15

131

15.6.2011

LST

20

1244440

155555

MUMBAI

16

132

15.6.2011

CST

20

1244440

24888.8

MUMBAI

17

133

21.6.2011

LST

311110

38888.75

MUMBAI

22.6.2011

LST-ONLY
3 OUT OF
5 TAKEN

311110

38888.75

MUMBAI

132

8337748

878885.8

18

135

Vch Type

Quantity

Value

Tax

Total sales
amount

Sales tax
paid

8337748.00

878885.80

S.no.

Bill of entry
&
Date

Bill of Entry No
3556605 dt20/05/2011

Challan
&
Date

Item
description

TR-6 Challan
2001176397
dt31/05/2011

VG-8000- Top &


Top
CABLE 4 PIN
ARM PAD

Total
quantity
of import
on which
SAD is
paid

Total SAD
paid

160

193766.00

Total
items
on
which
SAD
refund
is
claime
d
160

Sad refund
claimed

70

884.00

00

00

70

5788.00

00

00

193766.00

VG-8000

S.No.

Vch No.

Date

Vch Type

Quantity

Value

Tax

Place

141

28.6.2011

LST

124444

15555.5

MUMBAI

143

28.6.2011

LST

124444

15555.5

MUMBAI

144

28.6.2011

LST

124444

15555.5

MUMBAI

145

147

28.6.2011

LST

124444

15555.5

MUMBAI

01.07.11

LST

62,222

7777.75

MUMBAI

149

04.07.11

LST

497776

62222

MUMBAI

150

05.07.11

LST

311110

38888.75

MUMBAI

151

05.07.11

LST

435554

54444.25

MUMBAI

152

06.07.11

LST

124444

15555.5

MUMBAI

10

156

20.6.2011

CST

20

1244440

24888.8

DELHI

11

157

20.6.2011

CST

19

1182218

23644.36

DELHI

12

158

20.6.2011

CST

248888

4977.76

DELHI

13

161

20.6.2011

CST

124444

2488.88

DELHI

14

LST-14

29.6.2011

LST

435554

54444.25

DELHI

15

172

30.6.2011

CST

124444

2488.88

DELHI

16

LST-15

01.07.11

LST

10

622220

77777.5

DELHI

17

175

04.07.11

CST

435554

8711.08

DELHI

18

176

04.07.11

CST

311110

6222.2

DELHI

19

177

05.07.11

CST

311110

6222.2

DELHI

20

185

08.07.11

CST

124444

15555.5

DELHI

21

184

08.07.11

CST

124444

15555.5

DELHI

22

186

11.07.11

CST

248888

4977.76

DELHI

23

187

12.07.11

CST

248888

4977.76

DELHI

24

189

12.07.11

CST

124444

2488.88

DELHI

25

181

13.7.2011

CST

248888

4977.76

DELHI

26

191

13.7.2011

CST

311110

6222.2

DELHI

27

198

18.7.2011

CST

124444

2488.88

DELHI

28

199

18.7.2011

CST

186666

3733.32

DELHI

29

200

18.7.2011

CST

10

622220

12444.4

DELHI

30

202

19.7.2011

CST

311110

6222.2

DELHI

31

205

21.7.2011

CST

311110

6222.2

DELHI

160

9955520

538842.5

Total sales
amount

9955520.00

Sales tax
paid

538842.50

S.no.

Bill of entry
&
Date

Bill of Entry No
3778548 dt13/06/2011

Challan
&
Date

Item
description

TR-6 Challan
2001346441
dt20/06/2011

VG-8000- Top &


Top

Vch
Type

Quantity

Total
quantity
of import
on which
SAD is
paid

90

Value

Total SAD
paid

109444.00

Total
items
on
which
SAD
refund
is
claime
d
90

S.No.

Vch No.

Date

211

22-7-2011

CST

186666

3733.32

DELHI

213

22-7-2011

CST

62222

1244.44

DELHI

214

22-7-2011

CST

124444

2488.88

DELHI

219

25-7-2011

CST

62222

1244.44

DELHI

228

26-7-2011

CST

124444

2488.88

DELHI

237

27-7-2011

CST

186666

3733.32

DELHI

240

27-7-2011

CST

124444

2488.88

DELHI

242

28-7-2011

CST

311110

6222.2

DELHI

247

08-02-2011

CST

124444

2488.88

DELHI

10

255

08-05-2011

CST

62222

7777.75

DELHI

11

256

08-05-2011

CST

62222

1244.44

DELHI

12

258

08-09-2011

CST

62222

1244.44

DELHI

13

262

08-10-2011

CST

497776

9955.52

DELHI

14

263

08-11-2011

CST

311110

6222.2

DELHI

15

264

08-11-2011

CST

13

808886

16177.72

DELHI

16

267

08-12-2011

CST

124444

2488.88

DELHI

17

LST -20

08-12-2011

LST

62222

7777.75

DELHI

18

268

08-12-2011

CST

10

622220

12444.4

DELHI

19

289

22-8-2011

CST

62222

1244.44

DELHI

20

307

29-8-2011

CST

62222

1244.44

DELHI

21

315

09-01-2011

CST

124444

2488.88

DELHI

22

319

09-02-2011

CST

124444

2488.88

DELHI

23

320

09-05-2011

CST

435554

8711.08

DELHI

24

327

09-05-2011

CST

186666

3733.32

DELHI

25

330

09-05-2011

CST

10

622220

12444.4

DELHI

26

331

09-05-2011

CST

186666

3733.32

DELHI

92

5724424

127555.1

Sad refund
claimed

109444.00

Total sales
amount

5724424.00

Sales tax
paid

127555.10

Tax

For M/s Vigen Healthy Tech India Pvt. Ltd.

Authorised Signatory