Jio Fiber

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Reliance Retail Limited

1st Floor, Wing-A B, Fortune Tower, Chandrasekharpur


Bhubaneshwar, Khorda, Odisha Odisha Odisha 751023

(Original for Recipient)

Tax Invoice

Invoice No : 21R25I9999307758 Invoice/Payment Date & Time : 13 Jul,2024 10:13:19

PAN No : AABCR1718E GST No : 21AABCR1718E1Z1

Order Ref. No. : TB000038N2DX Payment Ref. No. : 10832409600931773000

Mode of Payment : Credit Card

Customer Name : GOURAB SAHOO Place of Supply : 21 Odisha

Jio Number : 6613562656 Customer Address : At- Katasahi, Po- Sahidnagar Odisha
756116

Sr. Taxable
Item Name HSN/SAC Qty MRP/Unit( `) Discount( `)
No. Amount( `)

1 JioFiber_1M_999 998422 1 1038.40 0.00 880.00

2 Platform Services - JioFiber_1M_999 998439 1 140.42 0.00 119.00

Total Taxable Amount 999.00

CGST (9%) 89.91

SGST (9%) 89.91

Total Amount( `) 1178.82

Total Amount (in words) One Thousand One Hundred Seventy Eight Rupees And Eighty Two Paise Only

Telecommunication services to be provided by Reliance Jio Infocomm Limited. Platform services to be provided by Jio Platforms
Limited. All disputes are subjected to Mumbai Jurisdiction. Tax is not payable under Reverse Charge

Declaration : Certified that all the particulars given above are true and correct

Digital Signature

Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
CIN: U01100MH1999PLC120563 www.relianceretail.com
Reliance Retail Limited

1st Floor, Wing-A B, Fortune Tower, Chandrasekharpur Bhubaneshwar, Khorda, Odisha Odisha Odisha 751023

(Original for Recipient)

Payment Receipt

Payment Receipt No : TB000038N2DX Date : 13 Jul,2024 10:13:19

Order Ref No : TB000038N2DX

Customer Name : GOURAB SAHOO Customer Address : At- Katasahi, Po- Sahidnagar Odisha
756116
Jio Number : 6613562656

Sr.
Plan Details Qty MRP/Unit( `) Total( `)
No.

1 JioFiber_1M_999 1 1178.82 1178.82

Total Amount ( `) 1178.82

Total Amount (in words) One Thousand One Hundred Seventy Eight Rupees And Eighty Two Paise Only

Declaration : Certified that all the particulars given above are true and correct.

This is a computer generated payment receipt, hence does not require signature.

Registered Office: Reliance Retail Limited 3rd floor, Court House, Lokmanya Tilak Marg, Dhobi Talao, Mumbai - 400002
CIN: U01100MH1999PLC120563 www.relianceretail.com

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