Tax Invoice/Bill of Supply/Cash Memo
(Original for Recipient)
IRN/QR Code:
Sold By : Billing Address :
COCOBLU RETAIL LIMITED SURAJ S NANGARE
* Emporium Industrial Park India Pvt Ltd, Rahaka Chinchghar, House No. 33 C, Wada, Palghar
and Ranika Singhola, Village Rahaka,, Tehsil, VADA, MH, 421303
Nimot PS, Sohna, IN
GURUGRAM, HARYANA, 122103 GST Registration No: 27BURPN1375D1ZD
IN State/UT Code: 27
PAN No: AAJCC8517E Shipping Address :
GST Registration No: 06AAJCC8517E1ZP SURAJ S NANGARE
Suraj Nangare
Building no. 15-B, Room No. 1, Central Park,
Agashi Road
VASAI VIRAR, MAHARASHTRA, 401303
IN
State/UT Code: 27
GST Registration No: 27BURPN1375D1ZD
Place of supply: MH
Place of delivery: MAHARASHTRA
Order Number: 405-7747041-4791522 Invoice Number : DED4-3208732
Order Date: 13.10.2025 Invoice Details : HR-DED4-1271137075-2526
Invoice Date : 16.10.2025
Sl. Unit Net Tax Tax Tax Total
Description Discount Qty
No Price Amount Rate Type Amount Amount
1 KLOSIA Women Printed Anarkali Kurta and Pant Set with
Dupatta (in, Alpha, S, Pink) | B0FDG84NS5 ( B0FDG84NS5
)
₹675.24 ₹0.00 1 ₹675.24 5% IGST ₹33.76 ₹709.00
HSN:62041200
Shipping Charges
HSN:62041200
₹38.10 -₹38.10 ₹0.00 5% IGST ₹0.00 ₹0.00
TOTAL: ₹33.76 ₹709.00
Amount in Words:
Seven Hundred Nine only
*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)
Please note that this invoice is not a demand for payment
Page 1 of 2
Tax Invoice/Bill of Supply/Cash Memo
(Original for Recipient)
For COCOBLU RETAIL 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)
Please note that this invoice is not a demand for payment
Page 2 of 2