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GST No.: ______________ Delivery Challan Original For Recipient

Pan No.: ______________ (Non Returnable) Duplicate For Transporter
State : ______________ State Code: Triplicate For Supplier

Challan No.: Company Name

Dated:
Address of the company: _______________________
Ph. No.: _______________________
Email: _______________________
Name: Transport
Address: G/R No.:
Vehicle No.:
GSTIN: Cartons
State: State Code: Place of Supply
Please received the following materied in good condition & order:
HSN Totral Amount
Sr. No. Description of Goods Code Qnty. UOM Rate Before Tax

Total Amount in Words: …………………………………………………………………… Total Amount Before Tax:

………………………………………………………………………………………………………….. Add: CGST %
………………………………………………………………………………………………………….. Add: SGST %
Add: IGST %
Total Amount : GST :
Total Amount After Tax :
Certified that the particulars given above are true and correct

For Company's Name

Issuing Clerk Receiver Signature Auth. Signatory