Government of Karnataka

(Department of Commercial Taxes)

e-SUGAM FORM
See sub Section(2-A) of Section 53 read with Rule 157(1)(a)
Sl.No:12215889088

Office of LVO of the Dealer Uploading

(a) Name and address of the Dealer Uploading

LVO-0380
SUJAY ENTERPRISES

(b) TIN

29440109865

(c) Date of Uploading the details

20/05/2014 05:47 PM

(d) Date of Transportation of Goods

Place:

20/05/2014

(i) From

BELGAUM

(ii) To

PUNE

II
(iii) Transit Place (if any)
Description of the goods:
(i) Name of goods consigned

MACHINERY AND PARTS - MACHINED

COMPONENTS

(ii) Quantity or weight

51 UNITS,540.000 KGS
III

(iii) Taxable Value

72581
(iv) VAT/CST Collected
1452
(iv) Other Amount if any
0
(v) Total Amount
(i) Name and address of the owner of the goods
vehicle or vehicle by which the goods are
consigned

IV

74033
GANGA SAGAR TRANSPORT

(ii) Registration number of the goods vehicle or

vessel
(iii) GC/LR No.
(iv) GC/LR Date

VI

(v) Transporter Mobile No (if any).

Category of Transaction
Details of consignor and consignee as per Category:

Inter State After Sale

(i) TIN of Consignor

29440109865

(ii) Name and address of Consignor

SUJAY ENTERPRISES

(iii) TIN of Consignee

27090007901

(iv) Name and address of Consignee

AIROTEK P C P PVT LTD

(v) Document No.

8 - Invoice

(vi) Document Date

20/05/2014

Date & Time of Printing: 20/05/2014 05:47 PM